Mindfulness

Mindfulness is paying attention to your thoughts and feelings in the present moment.   It can be a way to develop resilience and cope with the demands of an academic or clinical course. 

Here is a not very systematic selection of useful looking links:

NHS Behind the Headlines, on mindfulness to prevent a relapse of depression.

NHS Choices: Mindfulness for mental wellbeing

Useful looking articles include this systematic review of systematic reviews, published in PLoS One by Dutch and American researchers, and a systematic review of mindfulness for reducing stress in health individuals, published in the Journal of Psychosomatic Research by American and Canadian researchers, and this British Journal of General Practice introduction to using mindfulness in general practice.

The US Department of Veterans Affairs have an "evidence map".

Monash University in Australia has major interests in mindfulness, and includes it in health curricula.   Nearer home (mine, anyway, as of course I don't know where you are!) is this page at Bangor University in North Wales.

I only looked in PubMed, and have not looked at individual studies or reviews of mindfulness' uses in particular specific conditions.   I suspect looking in the psychological and psychiatric literature using PsycInfo would be beneficial.

Drones

Not the bee, but unmanned aerial vehicles.

Drones as a PubMed search finds 255 but some relate to bees.

This:

unmanned aerial vehicle* OR unmanned aerial system* OR uav* OR unmanned aircraft

finds 310.  

UAV is also "unicuspid aortic valve", which will be a few of that total.  UAS is another possible acronym, but this is also a gene, so adding it into the search multiplies the number of results by 10!

If you want to buy a small drone, with a range of a few metres and a battery life of a few minutes, you can do so at the Apple Store (I now know, following a trip to one for something else!).  

Many of the drones in the news at the moment are there because of their military uses, but they do have medical, health and scientific uses.  Here are some, from a quick scan of those PubMed results:

• Sampling the air, or dust;
  
• Mapping weeds, tern colonies, chimpanzee nests;
  
• Transporting laboratory specimens or drugs;
  
• Monitoring environmental hygiene;
  
• Major incident management;
  
• Monitoring infectious diseases.  

One reference uses the term "multicopter", an unused synonym - adding 1 more to the 310!

Two people in academia with interests in drones are Noel Sharkey, of the University of Sheffield, and Andy Miah, of the University of Salford.

Critical appraisal: not just seeing what you agree with

It's the Labour Party Conference this week, and so on the Andrew Marr Show on the BBC on Sunday last, Jeremy Corbyn, party leader, was interviewed.   I was pleased to see some of the interview, and remarked to the family how good it was and how much sense I thought was in what Mr Corbyn said (see declaration of interest below!).   Ah, well, said someone close to me, you would think that, because you agree with him.

This set me thinking.  Did I have a biased view of what he said because I only saw those things that I agreed with?   Did I have a biased view because I overlooked things that I did not agree with?   And that set me thinking about critical appraisal.

Reading the whole paper

One reason for critically appraising a research article is to see if it applies to your research or clinical practice.   Is another to make sure that you don't see only the things in it that you agree with?   I do think (and have said so to students) that critically appraising a paper is a way to make sure that you read the whole thing, and not just the bits that you find easiest.  For me, the statistical parts of a paper are more difficult, and are likely to be the bits I skip over.   If I am reading with a checklist like CASP, then I am made to read those bits, as I can't complete the checklist if I don't.   Does a checklist help you see all things in a paper and not just those things you agree with?

Which papers to read?

Is there a danger that when selecting papers from a list of search results, that I will still choose those items that I agree with, whose titles reinforce things I already "know" or have decided?

Are there criteria to use to select references from a list to read in full?   If you are doing a systematic review, then you look for things that match your inclusion criteria.  If you are looking for high quality evidence to inform patient care or clinical practice, then you critically appraise the evidence.  But if your search finds 50, how do you choose which to select for that detailed critical appraisal?   I have talked in teaching sessions about looking at titles, and then abstracts, to decide which to look at in full, but what are you looking for when you review titles and abstracts?   You are comparing them with your answerable question, the search question you formulated using PICO or a similar scheme.  Do you think they may contain an answer to that question?

Declaration of interest: as you might be suspecting by now, I am a party member (I joined a year ago or so) and I did vote for Jeremy Corbyn. 

Seagulls

When we lived in Aberdeen, we quickly learned that eating fish and chips outdoors was dangerous.  The seagulls would come to help themselves, and steal scraps.  If you did not drop scraps, they would steal from you without asking.  And the seagulls were Enormous.  In Tobermory on the Isle of Mull, they wait around the excellent fish and chip van on the harbour, although they don't steal in the same way.  Not yet, anyway. 

Seagulls have been in the news over the summer for attacking pets and people, sometimes causing nasty injuries.  I do remember news reports when we were in Aberdeen that if you had gulls nesting on your house, you needed to watch out for them attacking you if they had chicks.

The recent BBC programme Big Blue Live was very good, looking at life in the seas and on the coast around the UK and beyond.  It had a feature about gulls, looking at one man who had taken steps to make them behave by waving sticks at them when they came from neighbouring buildings into his garden.  This seemed to show them what was what, and their behaviour improved.

So, what information is out there about badly behaved gulls?   What action can you legally take?   What should you do if one tries to steal your chips?  In addition to the sites below, I think it would be worth checking the website of your local authority - several appear in the first page of Google results.

RSPB on urban gulls

RSPB on gulls and the law

NI Direct

Interestingly, there is a lot of information here about deterring gulls, but rather less on what to do if you are attacked by one.   

Skuas are known for doing the same - my parents tell stories from their visit to Shetland of getting too close to nesting sites of bonxies, as they are known there, and having to wave sticks in the air so the birds attack the stick and not their heads.   The Skuas, by Robert Furness, has a chapter about skuas diving attacks on humans, but because I have only seen what is available in Google Books (not all of the book), I don't know if he has any advice on what to do if they do attack.

(I do know there is no such thing as a seagull, as there are many species of gull, but I am hopeful that you know what I mean if I use the word!).

Media literacy, or how to read health stories in the news

I started writing this during the recent Labour Party leadership campaign, and have returned to it while doing an excellent MOOC course from Cardiff University, The Informed Health Consumer, one week of which was concerned with the reporting of health stories in the media.

Here are some of my thoughts about reading health stories in the news.

1.  Read the story, and not just the headline.   Is the headline written by the same person who wrote the story?   I am not sure it is, although this reveals my lack of media literacy!   Reading just the headline is perhaps like reading only the title or abstract of a research article.

2.  What motives do the story's authors have?    Or the newspaper?    

3.  Is what the story reports the whole story?   What are other reports saying?  

4.  Have the authors of the news story read the research study they are reporting?  Or just the press release?   And what were the motives behind the press release?

5.  What did the original research actually say or do?   Who did it?    I have memories of stories that drug A is a cure for disease B, or that eating a particular thing makes you live longer, but what did the original research say?   How many people were involved?    Or was it animal research?  Was it a "front group" (effectively a lobby group, trying to look like disinterested people).

If we are going to read a newspaper story about health critically, what should we be looking for?

One of the tutors on the Informed Health Consumer is Andy Williams, a journalism researcher.   This adds an interesting angle.   One of the units lists "science news values", things which journalists look for when reporting science and health, or things that may be shown.   These are

• Inaccurate reporting of uncertainty, or over extension, so for example, reporting a study that shows marginal risk of cancer in mice, over-extending the results to say that the same thing causes cancer in humans.
  
• Focusing on studies that report risks, thus suggesting the world is a riskier place than it is.
  
• Simplification - of course it is a valuable thing about reporting that it can simplify technical things, but things can be oversimplified and in the process distorted.
  
• Serious disagreements are always reported, suggesting that science has more conflict in it that it does.
  
• Human interest angle - of course, this is another positive thing about news reporting, but the risk in health stories is that a report of one person drinking tea and getting cancer is used to suggest that drinking tea always causes cancer.

The course uses some news stories that were picked up by the Behind the Headlines feature on the NHS Choices website, which is an excellent place to look at how health stories are reported.  Behind the Headlines chooses a story picked up by the press, and looks at the original research reported.

Finally, some proper advice on reading health news, from NHS Choices.   This advice is also reproduced on PubMed Health.

Marie Sklodowska Curie

Another BBC programme (see also the post about gender identity) was a programme about Marie Sklodowska Curie.   I can't find a website for the programme, which is what happens when you don't make a good enough note about something!

Anyway, I knew something about her scientific discoveries and knew that she had died of the effects of radiation, although she lived longer than I thought.

But I knew nothing of the fact that the Nobel Committee in 1903 wanted to award a prize only to Pierre, her co-worker.   And nothing of the negative reactions to her relationship with Pierre Langevin - he was married, she was not (she was a widow, as Pierre had by this point been killed in a road accident), but she seems to have been the recipient of criticism.   I also did not know that she and her daughter had provided mobile X-ray units in World War One, and that this probably contributed to her death.

An internet search for information about her is interesting.  Some of the results are of course about the organisation Marie Curie, which works with people living with terminal illness.   A lot of the results about her do not seem to mention this sort of issue at all.

Two that do are Wikipedia, and this site from the Chemical Heritage Foundation, which sets her in the context of oral histories of other female chemists.  

A search of Google.fr finds a lot about an EU fund for career researchers, named after her, and this interesting article in Le Courrier de Pologne, which reminds me that the programme referred to the transfer of her body to the Pantheon, in the 1990s.

The same search finds this English language article in the magazine 21st Century Science and Technology, the full version of which makes reference to the controversy over awarding the Nobel Prize to a woman.

A search of the English speaking Google for her, adding the word sexism, turns up:

This, from The Mary Sue, about the Academie Francaise des Sciences turning down her application for membership in 1911, and this from Wired;

And this, from The Community Alliance; 

And finally, there is a new film in production about her life. 

Beyond my linguistic skills, sadly, but which perhaps would turn something up, is a search for Polish language material.  I do know that the "l" in her name needs a bar across it but the technical term for this and the technical knowledge to do it are at the moment beyond me!

Gender identity

While in Scotland recently, I caught an excellent BBC Scotland documentary, called "Transsexual stories", following five trans women.  This link is to the stories of three of them - the programme itself is still on the iPlayer, but only for ten more days.  There was a lot in the programme that I had never thought about, and I was very glad I had caught it.  One of the five was a bus driver, who had been in the Army, and had attended reunions.  Her former regimental colleagues were very supportive of her, as were her transport colleagues.   Another was 17.  Some of the other residents of her town (unnamed) were less than supportive and less than helpful, but her parents were truly on her side and as supportive as you hope parents would be.  Another was working with college students and had taken part in a stand up comedy evening, to raise awareness and to try to put an end to the prejudice she had experienced when younger.

One of things I had not thought about was the process that people go through to change from the gender that biology has given them, to the gender that they feel they have.  Another was the idea that you would actually not feel at home in the gender assigned by biology, which was definitely something that was true for these five women - they all felt they were women, and not male.  Another was language, and I follow the BBC in referring to these five people as "she" and "trans women".  They had all been biologically male at birth, but felt they were women.  Some had completed the process, others not. 

More recently, there was a fascinating article in the Guardian about transgender children.  A girl who from an early age always wanted to be referred to as "he", and a boy, who as soon as she could talk, said she was a girl.  A fascinating and informative read, which makes reference to:

NHS Choices - Gender Dysphoria

Mermaids - a charity for children and teenagers with gender identity issues

Pace - the LGBT+ mental health charity

And there is also this gender identity information for young people, from Stonewall.

Grinders' disease

What is the connection between the 1945 film Brief Encounter and Sheffield?   Not the setting, or the destination of any of the trains (although there are signs for trains to Skipton and Bradford).  But the interests of Dr. Harvey, the male character played by Trevor Howard.   There is a scene where he talks about pneumoconiosis, and mentions that it can be caused by metal dust.

And this is grinders' disease, common among Sheffield grinders.  Sheffield City Morris dance to a song about the Sheffield grinder, and a bit of further research uncovers this song, sung here by Roy Bailey. 

At what is now Abbeydale Industrial Hamlet, grinders ground scythe blades, using water powered wheels.  The blades were exported worldwide.  There is information at Kelham Island Museum as well about the grinders, many of whom ground cutlery blades.  One of the hazards was that the grinding stone would break and the grinder be injured by the pieces flying off.  This is why health and safety is important, to prevent this sort of thing happening! Another hazard was the dust.  Bailey's song records the thought that 32 was old for a grinder.  Sheffield is built on metal related industries, but the impact of these industries on the people who worked in them is quite thought provoking.  Working with hot metal and working to shape it were and are hazardous pursuits.

Searching PubMed for the phrase "grinder* disease" gives you a message that the quoted phrase is not found (although see below), but it does then find more than 80 references mentioning both words.  Some are about diseases caused by vibration, but the most recent are from July 2014, one about silicosis in agate workers in Iran and one about "cobalt asthma" in valve grinders in the English West Midlands.   The last item in the list is titled "Contributions towards the pathology of grinders' disease of the lungs", from the Provincial Medical Journal of 1843, by J.C. Waterhouse of Sheffield.   This quotes earlier work about the disease, including work that provides figures that back up Roy Bailey's song's observations about how long grinders live for.  Waterhouse's article is in PubMed Central.

A search of PubMed for sheffield grinder* turns up a series of five articles by John Charles Hall, in the British Medical Journal for 1857, about the diseases of the Sheffield grinder.   These articles were themselves the first in a series about "Diseases of special occupations" and are also in PubMed Central.

Steel City Science also has a piece about the issue.  There is much more about Hall in Plarr's Lives of the Fellows (of the Royal College of Surgeons of England), 

That was indeed a brief encounter with grinder's disease!

But it is not over yet.  Here is a photo taken in September 2015 at Shepherd's Wheel, on the Porter Brook in Sheffield.  This grinding wheel was reconstructed and is now open at weekends.  Like workers in the 19th century, no protective clothing, but unlike them, the demonstration lasted seconds, enough to show how it was done and how loud it was, another thing that affected grinders, perhaps.

Playing doctors and nurses. And medical librarians

This is a toy figure belonging to my younger son.  Working on a large model boat, he managed to fall off, and needed treatment.  

He had hurt an arm.  We know about slings - about a year ago I had one.  So my son made a sling (more like a splint, I think) out of something he had to hand (sorry), to immobilise the arm.  Then we needed to know if there were any other injuries, so we conducted an X ray (with a torch).  You can begin to see the things we talk about at home - never have a medical librarian for a parent, is possibly the lesson.

Anyway, we discovered he had a head injury.  We know about those too - about a year ago I had one of those too.  So, we kept him under observation and asked him questions from time to time about if he knew where he was, and so on.  

And we found that he had broken ribs.  What to do with broken ribs?   We did not know.  I had not had any of those.  So, we looked it up.  I managed to persuade him in a previous episode of this game (which involved dinosaurs, which is another story) that medical librarians could look things up if doctors and nurses did not know what to do.   Or, they could show the doctor or nurse how to look things up.

So, I looked it up in a first aid book.  A bit there, but nothing about how to treat them.  I tried the impressive St John's Ambulance app, with similar results.   So, off to the computer, to NICE Evidence Search.  I tried rib fractures first, thinking that more medical language might be appropriate.  Among the results, some things about whether CPR causes rib fractures, but nothing immediately that answered the question of what we could do for this poor man.  So I tried broken ribs, and the first result was from Patient (as Patient.co.uk, a favourite with our medical students, is now called), and the second from NHS Choices.   Having looked at those, we decided that we did not need to bind the ribs up, in fact we should not do so, and that painkillers, rest, ice packs and sleeping standing up were what was required.  We also had information about when he should go to A and E.

There we are.  Imaginative play, but it reminded me of one of the purposes of medical and health librarianship.  You may know what to do, because you are a doctor or nurse, or you have done it before (assuming you did the right thing then, of course), but if you do not, you have to look it up, and that is where librarians come in.

Narrative medicine

We recently had a very good fortnight at the lovely Treshnish and Haunn Cottages on the beautiful Isle of Mull, and among the books on the shelves there was a copy of an issue of Granta about medicine (issue 120, Summer 2012, see here for a contents list  - full articles only available to subscribers). 

One of the pieces was by Chris Adrian, a published novelist who is also a paediatrician in the USA.  It was (or appeared to be) an address to students at his old medical school, about narrative medicine, but interspersed with his own story (of that of his character, but either way demonstrating the use of narrative).

Narrative medicine is the use of patients' or practitioners' stories in health care, or the use of fiction to explore health issues.  (Thanks to a slide presentation from the East Scotland Postgraduate GP Training Unit for that).

In the piece, there is mention of two articles in Academic Medicine, a real journal.  I was interested to check to see if these were real articles, and they appear to be. 

First, an article by Dasgupta of Columbia University.   This is PMID 15044169, about empathy, although PMID 25945967 is much more recent and by the same author.  (PubMed puts these two in a box at the top of the search results, as well as among the search results, which include results containing the word academic and the word medicine, as well as those results in the journal of that name).

And then, one by Kumagai of the University of Michigan.   Because foolishly I have forgotten to make any more detailed note about what the article was about, I am not sure which of the 20 odd results it is!

A PubMed search using the journal abbreviation (Acad Med) still looks for acad and med separately, but finds fewer red herrings than using the full words. 

A few links for more information:

Columbia University Medical Center's Program in Narrative Medicine - as well as details of the activities and courses of the Program, there is a bibliography of work by Program members.

King's College London has a Centre for the Humanities and Health, which has been involved in setting up an International Network of Narrative Medicine.

The BMJ has published a short series of articles about narrative based medicine (you will need a subscription to read the articles).  Trisha Greenhalgh and Brian Hurwitz, the authors of at least some of these articles, also wrote a book called Narrative based medicine: dialogue and discourse in clinical practice (ask your librarian, unless you are one, of course!).

Mental health on, or in, film

A conversation at home about F.D.C. Willard reminded me of Ian McEwan's novel "Enduring Love", for reasons which will become apparent in a later post.  There is brief mention of this novel in an earlier post about autobiography and biography as health literature, as it is a novel that deals with mental health issues.

Looking for material on the web about the novel, I found the Minds on Film blog from the Royal College of Psychiatrists, which has an entry about the film of the novel.  This blog has been going for five years (there is an index, by health condition, of the first five years) and features structured reviews of films that deal with mental health issues, each review summarises the story and addresses its relevance to the field of mental health.

The latest films reviewed include Still Alice (I have just ordered the novel for work, following my Dementia Friends training) and the television series The Outcast.

If you are looking for film or television that deals with mental health issues, I would recommend a look at Minds on Film.

Evidence based practice for seven year olds

Or, "to rinse or not to rinse".  

Towards the end of last term, it was health week at my younger son's school.  Parents were invited in to take part in a lesson about oral health, with the teacher and pupils talking about different types of teeth and doing some tasks.  One was to use dental disclosing tablets to show how clean your teeth really were.  Sadly I could not stay for this bit, but I did watch the video about cleaning your teeth.  This included the advice not to rinse your mouth after you had brushed.  I had never thought of this, but the idea was not to wash the toothpaste away, leaving the flouride to remain working.

And then some weeks later, Dr Ranj on the very good Get Well Soon (CBeebies) had a programme about teeth, in which he was observed by my son rinsing.

So, who was right?  

I asked my lad about this.  Who was right?   Dr Ranj, he thought, was a grown up and a lot of grown ups did not know not to rinse.  His teacher had said she did not know, and so of course had I.  So, I asked, how did he know not to rinse?   The video had said so, he said.  How did he know the video was right, I asked.  Because the person in the video was a woman, he said.  

I am not sure which of Isaacs' Alternatives to evidence based medicine this is, although it occurs to me that since my lad is actually called Isaac, this may well be Isaac's Alternative!   Anyway, is there another explanation?   What is the evidence? 

NICE have a guideline on oral health, and there are recommendations relating to action that schools can take.    But nothing about rinsing (that I can see).

A search of NICE Evidence Search led me to a record in Central, about toothbrushing education, but not quite on the right topic.  It did however tell me there was a MeSH term Toothbrushing/, so I tried that in PubMed combined with the word rinsing.  This was on the right lines, and some of the related citations were useful looking.  One of those was indexed also with the MeSH term Water/Administration and Dosage (some of the other references were about mouthwash, not water).  Trying the two MeSH terms together finds five items, some rather old.  In this one, some children rinsed with water and some did not, and there was little difference in flouride retention (the abstract does mention that previous studies did indicate that there was).   This one compared rinsing methods (one involved mouthwash, and two water), but with a smaller number of people, and found there was a difference.

Then, I tried a search of PubMed using toothbrushing (water OR rins*), filtered to systematic reviews, and found this (which actually appears to be a report of a consensus meeting, thus being an example of the problem of using a preset limit!).  An examination of the full text is needed to see what the recommendations are.  The abstract suggests that studies come to various results and that the evidence is of varying quality, although international guidelines, interestingly, come to the same conclusion (the abstract does not say what this is).   The full text seems to be freely available, and says "The consistent message emerging from the guidelines in Table 2 is to spit and avoid excessive rinsing with water" (in the section headed "Clinical guidelines"), based on four referenced clinical studies, although it does say that the evidence levels and the methods used to grade the evidence vary.

Is there something odd about this paper?

Or cats and critical appraisal.

I wrote in the previous post about F.D.C. Willard, co-author of a paper on low temperature physics, and actually sole author of another in French a few years later.   Willard, as the lead author of the first paper, J.H. Hetherington admitted some years later, was in fact a cat, added to the paper as a reaction to editorial policy about the use of "we" when there was only one author.   

I used to do a drop in workshop for research postgraduates on critical appraisal, which I started after talking to one of the departments I worked with about whether there was a need for such a thing.  Because we never knew who would be there, and because there might be people from a wide range of disciplines, the session had to be fairly general.  I devised a critical appraisal checklist to work with any discipline in the (as it was then) Faculty, which covered medicine, biological sciences and psychology.

F.D.C. Willard (Chester to his family) was a way into the idea that everything is not always what it seems with a journal paper.   If Hetherington had not said, we would of course never know that there was anything unusual with this paper, and the unusual thing was not to do with the physics.  My point was that if we conduct a critical appraisal of a paper, we might well spot any unusual things.  As part of the workshop we then conducted a critical appraisal, using my checklist.  With participants potentially from such a wide range of disciplines, choosing a paper was difficult (and I also had to be able to understand it!).

So, we appraised this paper from the Annals of Improbable Research.  This quite often worked well, but there were times when the humour of it was difficult for some of the participants, coming as they did from a range of cultures.

So, how do you know that there is something unusual about a paper?

Here are some possibilities:

• A critical appraisal.  Part of this is of course to see if the paper applies to your studies, research or patient, but part of it is to examine the methodology.  There might be cases when the paper passes the critical appraisal test, but there is still something unusual.  Maybe one of the following will help:
  
• Look for an erratum, corrigendum or retraction (we talked about those in that critical appraisal session);
• Letters and other responses, if the journal publishes them.  The BMJ allows "rapid responses", some of which become letters in the journal, something that the journal has always published;
• Comments on the journal website.   I am not sure how many specialist journals allow this;
• Blogs and other discussions about the article;
• Media coverage - perhaps only after something odd has been discovered (other things that make it into the media are perhaps articles that are thought to be significant, ground breaking, or have eye catching press releases - I have no evidence for any of these statements!);
• Check a systematic review of the topic and see if the paper in question (assuming it is a type that could be included in one) is in or out, and check how the results compare to the others in the review and to the results of the review.

If there is none of this, then I think you would need to find other studies of the same thing and compare results.  

F.D.C. Willard, the cat who wrote papers

I had forgotten about F.D.C. Willard.  

Some years back, I referred to him in a class on critical appraisal, as a way into the idea that journal articles are not always what they seem.

I was reminded, and delighted to be so, by The Scholarly Web column in today's THE (6-12 August 2015, p. 21), which was talking about the Academia Obscura blog, which mentions it.

So, this is the story.   This paper in Physical Review Letters, in low temperature physics, was written by J.H. Hetherington.  A colleague of Hetherington's pointed out that the journal's rules said that if there was one author, you could not say "we" did this or "we" found that, but you must write "I".  To avoid this, Hetherington (a real physicist and author of 40 papers indexed in Web of Science) added his cat, F.D.C. Willard as co-author.  The cat was called Chester, his father (the cat's) was Willard, and F.D. is (I used to ask the students if they could guess) for Felis domesticus.  

This paper has been cited 59 times in Web of Science, 

The story is recounted in:

Nickon A, Silversmith E.F. Organic chemistry: the name game. Modern coined terms and their origin.  Elsevier, 2013

Stall S. 100 cats who changed civilization: history's most influential felines. Quirk, 2011

Weber RL. More random walks in science.  CRC Press, 1982.  (A Google search turns up a book in German, called Kammerphysikalische Kostbarkeiten, which turns out to be a translation of this).  This, I think, is the book where I found the story.

The relevant sections are all in Google Books.   There is also an article in Wikipedia that tells the story, with a few developments I did not know about, and some references (although some are broken links).  

And (added the day after I wrote the original post, and causing some amendments), Hetherington's account of it is in this article from Physics Today from 1997 (you will need a subscription or payment to read the whole article).

MeSH on Demand

Does MeSH on Demand have possibilities for identifying thesaurus terms for use in a search, as I wondered if in a previous post?

MeSH on Demand is here: http://www.nlm.nih.gov/mesh/MeSHonDemand.html.  There is information about it in this NLM Technical Bulletin article. 

As a first test, I entered this text:

The use of antibiotics to treat otitis media in children under 5. 

MeSH on Demand suggests:

Anti-Bacterial Agents
Antibiotics, Antitubercular 
Child
Dermatologic Agents
Humans
Otitis Media

There is a disclaimer that says that humans might have come up with different terms, and that MeSH on Demand might suggest terms that are not in the text, or miss ones that are.  It does not assume any prior knowledge of MeSH.

I would have come up with the first and last terms, and humans, although I think that would be included implicitly if you include an age group.  I would have chosen something more specific than Child.

If you explode the first term, Anti-Bacterial Agents, you would include Antibiotics, Antitubercular.  There is no advice that I can see from MeSH on Demand about exploding.  If you use PubMed, exploding would happen by default.  

I would not have come up (at least, until I had examined some search results) Dermatologic Agents, so that is interesting and I would explore that.

There is no guidance from MeSH on Demand about how to combine terms.   There is also nothing said about freetext terms that you might use.

As a second test, I input the abstract from an reference from PubMed, and the resulting list of suggested MeSH terms had a very small overlap with the actual terms applied to that reference.  Indexers do look at more than the abstract, so there may be ideas in the article headings, conclusions and tables and figures that are not in the abstract.   Interestingly, Philippines/ is suggested (it is mentioned in the abstract) but is not actually applied to the reference. 

And as a third test, I used a search involving a drug and a condition that I had used as an example before.  MeSH on Demand identified the disease MeSH term I had chosen, and a drug MeSH term I knew about but had rejected (as too broad), plus a MeSH Supplementary Concept (the idea of those was new to me, I have to say, and I am not yet sure how you search it in Ovid!) and a MeSH term for the part of the search I had decided to deal with by means of a publication type limit or filter.   So in this case, MeSH on Demand was useful as a source of ideas.

Health vignettes

Health is everywhere, which is one reason why being a health librarian is so appealing and compelling.

I made a journey through a particular part of my home city.  At one end of the journey, shop staff were talking to each other about people they had observed through the window.  There was a man who was having what might have been a fit, who then refused the ambulance that the shop staff called for him.  There was another who tripped and fell on the tramlines.  And there was someone who had fallen from their bike on the tramlines.  If this has happened to you in Sheffield, you should put the details on this website.


And at the other end of the journey there was a parent and children walking, with the parent explaining to their children something about the health of a grandparent and how it was affecting them.

Bees and neonicotinoids, and choice of database

There are petitions circulating online at the moment about the effect of neonicotinoid insecticides on pollinators like bees, and asking for those insecticides to be banned.

Neonicotinoid insecticides were banned, it is said on scientific advice, but now are not, it is said on pressure from the manufacturers and farming interests. 

I have been signing the petitions, having become interested in bees since we had tree bumblebees living in the roof of our last house, and as part of my general pottering in the garden.  I have been involved in research into them and other pollinators by taking part in the University of Sussex's Bees 'N' Beans project (beans now harvested, keeping the results safe until I can submit them online!).   

Until we know the effects on pollinators for sure, we ought not to use neonicotionids. 

What is the evidence?

I searched PubMed for the two words bees and neonicotinoids, and as a test of its usefulness in life sciences more generally.  Limiting to review articles (although we do need to remember the potential pitfalls of review articles) finds this from 2014 by seven researchers, all at the time UK based except one, based in the Netherlands.  It summarises the evidence in several appendices and discusses laboratory experiments (where the dosage may be higher than in the field) and field experiments.

The search finds 69 items.  The search term bees is mapped to MeSH, but the other term is not.  So, I tried truncating neonicotinoid* and this finds 110.  Truncating in PubMed turns off the MeSH mapping, so is not always wise - you may find more with your search term in the title, but lose items found with MeSH mapping.  Here, though, since the first term did not map to MeSH, truncation is wiser.  

A search of Web of Science Core Collection for 

(bee or bees) and neonicotinoid* 

finds 234.  13 of these are reviews.

Importing the 110 and the 234 into RefWorks and removing close duplicates (I have to confess I did not check them all, I assumed they were indeed duplicates) leaves 157 (out of 234).    More work would be needed to see how many of those were unique to PubMed or to Web of Science. 

A general web search finds a lot of news and campaign information, but also this research review from the Xerces Society for Invertebrate Conservation, on the website of the Entomology department of Penn State University. 

Middle Eastern Respiratory Syndrome (MERS-CoV)

In the last hour or so up popped an alert on my phone from the Guardian, reporting that Manchester Royal Infirmary has closed its A and E department while it investigates two possible cases of this syndrome.

A search of Google for news shows that many other news sources are reporting the same story.

According to the Guardian, reporting Public Health England, there have been no new cases of MERS-CoV in the UK since February 2013.  This is PHE's guidance, first produced in 2012, but still being updated.     

NCBI have a MERS-CoV Resource Page, giving links to their MERS coronavirus database and other NCBI resources, including publications.  There are also links to WHO, CDC and other external resources, and also to HealthMap, which presents a map of cases, and includes the two in Manchester reported today.   You can click a country and see where in that country cases have been reported.

Here are some resources about MERS-CoV.   As well as the list, also try NICE Evidence Search - more comes up if you look for MERS-CoV than if you look for the full name.  

Other UK guidance

Having said that, guidance from Health Protection Scotland comes up if you use the full name, guidance produced in 2013, to raise awareness of the possibility of MERS-CoV in people returning from the Hajj.

Public Health Wales - a summary of symptoms, with links to other information, some advice for travellers, and (if you are in Wales and have a login) information for clinicians.

Guidance from elsewhere in the world

ProMed-Mail - at the moment (1830 BST, 27/7/15) there is nothing there about these possible UK cases, but ProMed-Mail is a good place to get up to date information about cases across the world.

Centers for Disease Control and Prevention - information about MERS and for clinicians and travellers, from this US Federal agency.

World Health Organization - a wealth of information, including an infographic of signs and symptoms, news, multimedia, current outbreak information, and links to information from WHO regions.  There is currently an outbreak in China and the Republic of Korea, and there are up to date figures on the WHO site.

European Centre for Disease Control and Prevention.

Post Ebola syndrome, and choice of search terms

On the BBC news recently was an interview with a survivor of Ebola, which made reference to "post Ebola syndrome".  A search of the web finds a lot of news items mentioning this term, a short Wikipedia page and an article from Medecins Sans Frontieres.  According to that MSF article, joint pain, eye problems and depression, among other things, can follow Ebola.

Another item found by a web search for "post Ebola syndrome" is this blog post on the H5N1 blog. It refers to an editorial in Lancet Infectious Diseases (the link in the blog post goes to the Lancet but here is the PubMed record):

Sequelae after Ebola virus disease: even when it's over it's not over.

Bausch DG.

Lancet Infect Dis. 2015 Apr 21. pii: S1473-3099(15)70165-9. doi: 10.1016/S1473-3099(15)70165-9.
PMID: 25910638

A search of PubMed for post ebola syndrome finds only 6 items, which are perhaps not the most relevant.  A search for ebola sequelae, taking the hint from this editorial, finds 89.   Among them is this, which is mentioned in that blog post:

Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study.

Clark DV, Kibuuka H, Millard M, Wakabi S, Lukwago L, Taylor A, Eller MA, Eller LA, Michael NL, Honko AN, Olinger GG Jr, Schoepp RJ, Hepburn MJ, Hensley LE, Robb ML.

Lancet Infect Dis. 2015 Apr 21. pii: S1473-3099(15)70152-0. doi: 10.1016/S1473-3099(15)70152-0.
PMID: 25910637

PubMed's Automatic Term Mapping maps post ebola syndrome to both relevant MeSH terms, virus and disease.  Searching for ebola sequelae does the same, but also to the subheading Complications.   This can be applied to the disease heading (Hemorrhagic Fever, Ebola), and effectively is a floating subheading with the virus heading (Ebolavirus).  Adding complications to the search (ebola (complications OR sequelae)) finds 89 as well.

However, using MeSH alone would find neither item from Lancet Infectious Diseases, as neither has been indexed yet. 

 

So, the literature searching lessons here - try alternative terms, try to identify the ones that are used in the medical literature and not just ones used in the general media, and try to find terms that make best use of PubMed's Automatic Term Mapping.  

Be strong, be resilient

Resilience has come up a couple of times recently.  One was in the lyrics of Grace Petrie's song "Inspector Morse" (1), and the other in a meeting with academic colleagues, in the context of dealing with negative feedback.  It made me look for some resources, which are here...

Communities can have resilience.  There is a definition here, in the context of dealing with emergencies.  So can people, for example, in this resource from the American Psychological Association.

Students, more specifically, need it too.   Here is the Higher Education Academy's research briefing about the benefits of emotional resilience in health and social care students.  What competencies are associated with emotional resilience (being able to cope with the emotional demands of working in that sort of profession)?

The Red Cross have some teaching materials about "building resilience", with scenarios.  Students are encouraged to think about what they would do in the situation described.   Their checklist of resilient behaviours looks very useful, and is:

• Not necessarily doing the first thing that comes into your head.
• Not freezing or panicking.
• Getting a good perspective on the situation – seeing it for what it is, neither exaggerating nor minimising its impact.
• Assessing the available resources, including non-obvious ones, for their potential to minimise harm or discomfort.
• Being creative with those resources.
• Asking those most affected, such as a first aid casualty, for their ideas and preferences. It sounds obvious, but it's often neglected.
• Calling on past experience, your own or other people's, of similar situations and using that as a guide or help.
• Reassuring others around you who may be dispirited or doom-laden while calming those who are over-reacting. 

Then there is "mathematical resilience", in this report from the Centre for Research in Education and Educational Technology at the Open University.  The report says, "Many people find it difficult to take part in mathematical learning, to the point where they exhibit anxiety or at least avoid engaging in any activity that could require mathematical reasoning. In this research we work with teachers in school to seek to develop a positive construct in learners, we call this construct mathematical resilience". (p.1)

Back to the negative feedback.  This is another blog post that mentions my older son (sorry, son).  At his school, he has been involved in gathering data from younger students, including about resilience in the face of negative feedback.  To make feedback less negative, the school uses the "WWW EBI" scheme to give feedback - "what worked well", "even better if". 

Reference
 
(1) the reference is at the end of the song.  I feel I ought to warn you that it is near a word that some would consider rude, and which is not a word to use in feedback!