Identity Crisis

Seeking balance, I am. For the past months, balance meant learning new things and acquiring new competencies which left this blog bloggerless.

That in turn was an opportunity to think about quitting it; after all, there are plenty of references in the blogosphere to the decline of blogging in general.

Today, though, I feel motivated to continue. A main reason is that I think of this blog as a social bookmarking venue more than a blog in the more commercial or networking sense. I post things that I find useful or that have been used recently in my patient education resource center. That makes it useful to me over time, as a record of trends and a place to store ideas, links, topics and vignettes that might otherwise be forgotten in the day to day rush.

I mean really, I would love to find a blog or other source of recommendations for consumer health information books and resources. I haven't found just what I need, so I have to build it. Finding balance will mean posting more often, possibly in less detail and with a less perfectionistic attitude.

The other motivation for this post is to share a link to the Positivity Blog. I really like this post on solving problems, it is simple, realistic and motivational. nice!

More CDC coolness

Widgets- another way to add content to a hospital or library consumer/medical website.
See them here: CDC Widgets

Here are 2 that might be nice, and the easy instructions for adding them to your blog or page.

Depression medication guide

Discovered a great resource on the Agency for Healthcare Research and Quality webpage. Its a concise but inclusive guide to antidepressant medications- one that actually answers questions a person might have if making a decision on using them. The site also provides a PDF of a version with pictures and nicer graphics as well as an audio and mp3 version, as well as other guides.

MedPedia; a better wiki for health

As a follow up to yesterday's post about the prevalence of Wikipedia as a search result for health related searches, I took a look at MedPedia.

MedPedia is a wiki for medical information, with content supplied voluntarily by medical professionals; MD's or PhD's only. While this alone does not guarantee accuracy or unbiased information, MedPedia's editorial policy is stringent and clear.

MedPedia's intended audience is "physicians, consumers, medical and scientific journals, medical schools, research institutes, medical associations, hospitals, for-profit and non-profit organizations, expert patients, policy makers, students, non-professionals taking care of loved ones, individual medical professionals, scientists, etc." This is a wide audience and the mix has potential to spawn vibrant and diverse communication.

MedPedia is a great alternative to Wikipedia for health information searches, providing relevant and authoritative content. Topics range from specific symptoms and disorders to management issues, health informatics and medications. Coverage is not consistent; the article for Pompe disease is quite comprehensive but there is very little on pelvic floor dysfunction. Many articles include images or links to video content, as well as sections on Controversy, Famous people, and Other Resources that include thoughtful and interesting links. I would explore MedPedia for these alone as they have potential to provide a fresh perspective on medical topics, one supplied by professionals who treat and interact with those affected.


Best feature? The Clinical or Plain English toggle choices. Because they are prominently placed and simply labeled, these tabs reinforce the obvious but overlooked fact that health information can and should be presented differently for different audiences. Though not nearly fully utilized yet, this is a great idea and one that I hope will be copied elsewhere. Today, the promise of MedPedia is greater than the delivery. What is there is promising, and I am left wishing it were more complete.

Simple, elegant, useful.

Wikipedia and health information

According to Online Health Information and Wikipedia/ Michael Laurent and Tim Vickers in The Journal of the American Medical Informatics Association (April 23, 2009), English Wikipedia is a prominent source of online health information compared to other online health information providers studied, in fact a higher average position (in Google results) than any other reference in the study (27 prominent health related websites studied).

Though I do use wikipedia myself, it has always been to get background information on a subject I am merely curious about, for a quick understanding when accuracy is not critical. For example, I've searched "vampires" and "Peer Gynt" and "paneer".

I hadn't realized the prevalence of wikipedia for health information searching, though. It seems that the reference questions we encounter at our resource center are not representative of what I read about online or in published research. I noticed this about the MedlinePlus Tag Cloud as well; that the most common search terms for Medline do not mirror the most common types of questions here. While most patrons don't mention which websites they use and I don't regularly ask them, I have never heard anyone refer to a Wikipedia search.

Today I took a look at Wikipedia to get a general feel for the quality of the health information. One of the "In the News" articles featured on the front page was the piece on Swine Flu. It contained a notice that "this article may require cleanup" and a disclaimer that Wikipedia does not give medical advice. Great so far.


The piece is quite long and contains 50 references, most to peer reviewed journals but also to news sources such as Times Online and Salon.com. The first outside link is to the CDC swine flu webpage, which is the source I would use at the reference desk for the most current news on the outbreak or for guidelines for prevention or treatment. Overall, the article was comprehensive, contained links to credible sources for further exploration and included information to allow the reader to independently assess what was presented. As a source of background on a news story about a health issue, I would not hesitate to use Wikipedia.



CDC Swine Flu News






Nations With Confirmed Cases
H5N1 Avian Influenza from PandemicFlu.Gov

Tag Cloud

I love the new tag cloud on MedlinePlus. They call it a search cloud and that is a good descriptive name for what it represents. It is made of an alphabetical list of the terms most often searched on MedlinePlus, updated daily. The larger and more bold terms are searched more often and smaller, lighter ones less.

The cloud is fun to play with; you can mouse over terms to see their numerical rank or click on them to see the MedlinePlus results. Studying the provides insights into the most common health concerns of those who use this online resource. There were 16 drug names, some generic names and some commercial. The term rhabdomyolysis is ranked 52 out of 100 today, with most of the results describing it as a possible but rare side effect of the use of statins to treat high cholesterol. Fibromyalgia is number 2, abortion number 3.

I really like looking at tag clouds to visualize topics; here and in Delicious and LibraryThing especially. It provides a great big picture view of things, makes it easy to find what you want and looks sharp.

teens and drugs

Today, on the NIDA for teens website, I found these fun, printable stickers. There are other download-able graphics and resources for teens including:
games
glossary
prominent find help links
quizzes
and games.

These are meant for teens; I imagine they could be used by 4H or other student led groups to create healthy messages for peers but also by consumer health library staff to create promotional materials or displays.


What I was looking for is reviews or a list of good books for parents or teens on substance abuse prevention and treatment.
I didn't find those;
but have to post another rave about the Cope Care Deal website, sponsored by the Annenberg Foundation Trust. Look here for free, downloadable books on mental health topics for teens and parents, the newest being:

I printed a copy today, haven't read it yet, though am anticipating great things as we have other titles in the series in our library and they are well written and informative.

As for the lists- I'll post if I find any!

Digital Storytelling

Once upon a time I sat on the bus reading:






Digital Storytelling: an emergent method for health promotion research and practice/
Aline Gubrium in Health Promotion Practice 2009; 10; 186

The article is about using digital storytelling workshops to explore ways to extend participation in digital technology use to those who may be on the wrong side of the digital divide, and explore a possible avenue to study participation in health research by this population. The author describes a digital storytelling workshop, which involves one on one mentors helping participants chose a personal story to tell, use images, video and voice to tell the story and then present the story to the group and later to a larger audience. Participants were taught to use the necessary computer programs, to identify elements of storytelling, to support and reflect on each other's stories and were given a safe forum for sharing their story with others.

This project was powerful for the participants and the author reports learning more about community based participatory research, making it worthwhile.

In terms of patient education for individuals, I think that segments of patient produced storytelling would make compelling content for materials designed to change behavior or motivate change.

There are several interesting website about digital storytelling, my favorites are:

Digital Storytelling
Center for Digital Storytelling

both have some nice resources and information; neither are particularly health or medicine related.

one caffeinated nerd-cyclist

(no, not the guy in the photo. Me.)


Yahoo news featured a story titled Coffee Lessens the Pain of Exercise describing a study that found that coffee kills the pain of athletic exertion.

I checked it out here (International Journal of Sports Nutrition and Metabolism, interesting stuff) and wow, do I like this sentence: The results support that caffeine ingestion has a large effect on reducing leg-muscle pain during high-intensity exercise, and the effect is moderated by anxiety sensitivity.

I didn't get to read the entire article (in the journal) but I did check out Robert Motl, the author featured in the yahoo piece on Biomedexperts because I like the topic. This is fun stuff to me and another excuse to post pictures of mountain bikers in action. Yes, I have had my bike that high off the ground, but no, I don't have photographic documentation, yet. Spin class does sometimes involve pain, and I do think about whether or not to have coffee in the afternoon before a class, and about what to eat before and after class or big rides.

Does more coffee= better ability to endure pain=more work in class=more fit blogger? I'll test the theory and report.

Reading these studies is fascinating. I'll leave you with a final thought, one that I often hear with sweat dripping down my nose:

" don't be afraid of pain. sometimes everything you ever wanted is just on the other side of fear"- spin instructor

photo: martscrazyhorse's photostream

CDC Health e-Cards- a great opportunity

The CDC has some innovative social marketing tools and a nice blog called Health Marketing Musings on the subject as well. One tool that caught my eye is these health e-cards. There are many, more than 100 and some incorporate video and sound. They link to content on the CDC webpage for consumers, most with a public health component. There are cards available in Spanish as well.

These could be used by consumer health librarians or health care providers, maybe sent to a patron or patient after a visit to reinforce any teaching done or just to connect with them again and provide another source of quality health information. They are simple to use, simply go to the site, choose a card, fill in the recipient's name, your name and a message and send.

Talking to Myself: My Top Consumer Health Information Websites

So, Pilgrimtinker, tell us about the websites you like and why.

Do you mean like LOLCats and 3 Quarks Daily?

No, I said no more LOLCats for today. Focus. Answer the questions! Here's #1:
What features make a consumer health website worth a visit? That is a pretty easy one- think reliability, authority, searchability, depth and clear purpose.

The topdog is MedlinePlus, unbeatable for comprehensive coverage, use of multimedia, resources tailored for specific audiences and currency. If this is your only source, you will still be well served.


But does it have to be a .gov or a professional association site?
Not necessarily, though few commercial site have managed to avoid overdressing with ads and viral flashing headaches.
Try WebMd; many of the elements that look like ads are actually part of the site. Too busy for me, but popular and the most fun to wander around.

MayoClinic , Cleveland Clinic and Family Doctor are in this category as well; worth a look, trustworthy and comprehensive with nice videos and blogs but occasionally distracting ad content.
Who do you admire?

The National Alliance on Mental Illness - NAMI- webpage. It manages to be many things for a wide audience of users and provide critical support to those dealing with mental health concerns. All with heart and style. The main menus are

• Inform Yourself
• Find Support
• Take Action

But the news features and the search function work well too. The site is replete with social networking tools, safe avenues for online communities and worthwhile resources.

What about speciality health search sites; which are worth a look?
I often use Labtestsonline for definitions and reference lab values. This site prints nicely and is easy to search.

The National Institute of Diabetes and Digestive and Kidney Diseases- NIDDK - is a huge warehouse of a site and often provides the practical, what-CAN-I- eat-then information needed by those planning meals or avoiding symptoms caused by conditions that affect the gastrointestinal system.

Surely there are more consumer focused health search engines out there. Didn't you miss some of the biggies?

Not really. If you have MedlinePlus, you have a great jumping off point and will find most of what you need. If you prefer something with more social networking, well, these site are usually disease specific, I'll have to tell myself about that another time. If you just need some variety, try WebMD for the best source of health related mind candy like "top 6 sex mistakes men make" or "is 4 the new 14?"

There are many, many more, but they are either more-of-the-same or full of lousy content. I watch them to keep up with trends in web design and marketing and to be aware of the hot topics in consumer health. But when I need to find useful information, its right back to MedlinePlus.

Internet Cool Tools

Yes, I am behind the times with a post about this great book- Internet Cool Tools for Physicians by Melissa Rethlefsen, David Rothman and Daniel Mojon, but today, I just stumbled across it on Nicki's list in Majors, a major source of medical and health care books for librarians.
















The book is for physicians but useful for anyone in health care interested in finding the best medical resources on the web. It includes guides to

• Google- basic, advanced, scholar and Google Health
• Finding people
• PubMed
• Third party PubMed tools
• Email alerts
• RSS
• Personalized start pages
• Podcasting/Vodcasting
• Blogs
• Wikis
• collaboration tools
• Social Bookmarking
• Keeping notes
• Social Networks

All with a medical focus and using short, descriptive text with lots of images and fun comics. I would recommend this book to anyone in health care or who uses the Internet regularly for medically related searches or work. It is especially useful to medical librarians or those who create course content for medical professionals on any online resources.
Great job, Melissa and David, and thanks!

Finish Line

Well, this oughtta teach me to make a blog promise; I had thought I'd review each of the ten of the AltSearchEngine's top ten health search engines in 10 days. hah.

Silly me, lesson learned. I'd tell you what I was doing instead but it might inspire a new meme, leading to mass blogosphere real-life truth-or-dare and you'd all find out why most of our neighbors don't speak to us. so, lets get this done:

Yottalook is cool. It searches for radiology images in free and subscription sources. It displays them ala Google with enough text to describe the source and context, allowing users to find a useful result they can use. Searches can be performed separately for web, images, journals, books and anatomy, or all. The images search has especially slick results, displaying thumbnails with the related text and links to more images in the same article.

A search for books confused me momentarily, bumping me into igoogle- Yottalook has an igoogle app. The journal search has some nice filters to narrow a search; some for type of image and others for type of publication or article. Anatomy searches offered those filters as well as further divisions of the term entered.

The verdict- I found this search engine easy to use and powerful. Considering that I have little experience searching for medical images, this tells me that Yottalook is well designed and thoughtfully created to be, well, idiot proof or at the least, beginner friendly.

Would this be a useful consumer site? Probably only marginally, for those interested in anatomy or really, really curious about their CT or xray results. Most others would find the results a bewildering display of black and white globs, blobs and disturbing black holes (if they are like me) or just kind of repetitive and inscrutable (me again, who is this about, anyway?).

And the skeletons? Just an excuse to mention Street Anatomy, a medical illustration blog with a really interesting galleries of anatomy tattoos and anatomical street art.

Almost There

Lalisio Literature is #9 on AltSearchEngine's top 10 health search engines post and is of the now-for-something-different bent.

Lalisio has nice vision and not quite there reality. The idea is to search booksellers, open access and for profit publishers at the same time, thus "Lalisio Literature" is a search engine designed to help you find the right literature for your research, studies, teaching and leisure"

My search for "substance abuse" returned older treatment manuals for sale on Abe Books (books is the default category, I have to toggle over to see open access or journal article results). And here is the fatal flaw, beyond older titles returning first- there is no value added here. If I click on the title of a book, I see only an image of the cover and the barest of bibliographic information, with no reviews or any other information. I have to select one of the sellers to learn more about the title.

I took a look at the open access results next. Unsure how they were sorted, I tried some of the limits. "persons" gave me articles about certain populations, and 2008 gave me the most recent articles. OK, not bad until I tried one of the tags under a title I was interested in, oops. Selecting epidemiological factors bumped me from "substance abuse in patients with ADHD" to "structural correlations in in protein folding tunnels". I would definitely use open access searches such as Bio Text, OAIster or the Public Library of Science search directly instead of Lalisio, if only to save myself a step.

So, briefly, Lalisio has a nice idea and a good enough interface but does not yet include enough of the big sources to make it a one stop tool. I applaud their idea and would use a resource like this if it could search more sources.

image credit: Vintage Fairy Illustration--Anne Anderson--Mommouth Book Of Fairy Tales--Fairies in the Woods - finsbry's photostream, flickr

NextBio

No stretch of the imagination can excuse my whimsy in using this photo here- it only serves as a glimpse into my world. It is from the Sacred Ride tour groups flickr stream, of photos from a ride in British Columbia, which I hope to do later this year. I had a great snowy ride myself this weekend, though without the mountain setting.

Ok, to the real post: I began this series of posts based on AltSearchEngine's top 10 health search engines expecting to review new consumer health information resources but I find that it contains resources for a wider audience than expected and have made several nice little discoveries. Kindof like a bike ride to an unknown destination? Nah, that's a stretch, forget it.

NextBio is a resource I would not have discovered without the top ten list; it searches published lifescience research and it's audience is looking for data, especially gene-centric data. I love the FAQ's because they clearly answer questions like:

Q: How does the "auto-complete" function with search suggestions work?
Q: What can I search for?
Q: What are the sources and associations?
Q: What is the "see other results" option for?
Q: What criteria does NextBio use to search for relevant literature?
Q: How does filtering of results work?

Wonderful! Providing these answers does all the work for me and is exactly the kind of thing I am wondering about when I test drive a search tool.

NextBio is more than a search tool, though, as they take the next step into social networking. NextBio offers community resources like a personal profile page and contacts, encouraging individuals to discover associations between their research and other's. Users can place data within the context other's experimental results and published articles and collaborate with those they connect with. The FAQ's provide clear instructions for uploading data and marking it so others can search.