Simple Pubmed Searches

PubMed is a service of the U.S. National Library of Medicine that includes over 18 million citations from MEDLINE and other life science journals for biomedical articles back to 1948. PubMed includes links to full text articles and other related resources. The search volumes at Pubmed are enormous!!

Many people i know do not derive the full benefits of that LARGE library – Pubmed. Most stop at simple article searches and then get lost in the thousands of results which pop up. The few who go for advanced search tend to stop at one or maximum two attributes. It has always been a bit hard to master the Pubmed maze. So now Pubmed has come up with a new improved design for its search Function.

Video by Melissa Rethlefsen, Librarian, LRC – Mayo Medical School

PubMed’s new Advanced Search screen is designed to replace the current tabs in PubMed (Limits, History, Index, etc.) and the Single Citation Matcher.Its more intutive and all the attributes are listed on one page to help you choose easily. I found it better than before. Take a look.

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-Distance education in Medical and paramedical sciences

Image by interplast via Flickr

In a developing country such as India, where an optimal level of health service is a dream to many, there are far too few health workers in training and the number of training institutions is far too few. To understand the gravity of the situation, ther r r re are more than 365,000 doctors, 264,000 nurses and 350,000 allied health professionals which includes Multipurpose Health Workers, Village Health Guide, etc. Whereas, proper training facilities exist only at a few institutions like National Institute of Health and Family Welfare (NIHFW), State Health and Family Welfare Training Centers. With a limited number of available training institutions, it is nearly impossible to train large numbers of medical officers and paramedical workers. Nearly 47 Health and Family Training Centers (HFWTC’s) and seven Central Training Institutes (CTIS) provide health and family welfare training to all categories of health functionaries in the country. These long-duration training programs attract a limited number of clients, and hence most of the institutions also organize in-house short-term training programs which has less than the desired impact on their functionaries.

Distance education is a relatively new concept which not only has the ability to train a large number of health care workers in a short time in a cost effective way but can also attend to skills of health care without diluting the quality.Distance teaching-learning often involves a multi-media approach to design, develop and implement independent learning programs through self-instructional materials, both in print and electronic media forms. Distance study allows self pacing for convenience and also facilitates learners having control over their learning. The various media used for distance education delivery include among others, print materials, audio and video programs, radio and television programs, tutoring and counseling, field visits, laboratory practicals, extended contact programs, and teleconferencing.

The following issues need to be addressed and considered for successful application of distance education programs for health professions:

1. Since health sciences deal with life and death and are therefore are more skill-oriented (rather than more knowledge-based), it is felt that providing basic beginning or early training in the field of health may not be feasible through distance learning. Being an innovative and flexible system, and having the ability to respond to emerging training and educational needs, distance education is more appropriate for inservice training of health personnel.

2. The academic programs have been confined to a limited area of health education and training. In order to meet the diversified and emerging needs of health workers, the programs and courses have to go beyond medical graduates to include a wide variety of need-based functional areas ranging from simple awareness programs to more complicated skill-oriented courses on epidemiology and health economics.

3. Application of sophisticated communication technology has to be done cautiously, keeping in view clients needs, cost, media behavior and infrastructure and facilities at the receiving end. In the developing countries including India, audio and television programs seem to be more feasible and promising. Furthermore, multi-media packages need to include a large amount of hands-on and field experience.

4. An issue to be deliberated is the provision of student support services for health workers and professionals. While compulsory counseling and extended contact increase the effectiveness of programs, these on the other hand pose problems to both providers as well as the receivers of health education. More practical-oriented courses need to have compulsory built-in face-to-face components; and work centers or practice centers at grassroots level with required instructional provisions would be more feasible than regular study centers.

In conclusion, it is worth noting that distance education has tremendous potential for providing education and training programs to different categories of medical and paramedical personnel as a means of helping achieve the goals of HFA. In addition to the national agencies such as the Ministry of Human Resources Development, the Ministry of Health & Family Welfare and Indira Gandhi National Open University, international agencies such as WHO and UNICEF need to play increasingly prominent roles in facilitating the achievement of national and institutional targets. Proper use of ISRO provided satellite communication facilities can make distance education courses an important aspect of ongoing medical education.

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-Cannot treat without I.T support?

We know that wider adoption of healthcare information technology (HIT) results in better patient care. Here, in India, most medical students learn to use HIT after they start working as Doctors. Many medical students use the net to study, at a personal level, but institutional use of IT in Indian Medical colleges and associated hospitals is very low.

But here is a study with a very different perspective regarding HIT.

“About 80 percent of the 328 Vanderbilt graduates who participated in the study were working in an environment with less IT. According to the study, they reported “feeling less able to practice safe patient care, to utilize evidence at the point of care, to work efficiently, to share and communicate information and to work effectively within the local system.”

Used to IT support in decision making, Medical students were left flabbergasted when they had to provide healthcare from Knowledge. Definitely not a very good sign.

Read the study on Healthcareitnews here.

Meditel 2008 @ Chennai, India

Chennai-Image via Wikipedia
The use of ICT ( Information and communication technologies) for Health care in India is still very limited. Most of the efforts in this direction are sporadic and rudderless.There is no dearth of skilled manpower in this field, but a unified plan of action is still awaited.

Medical computer society of India has taken the lead to organize a national conference on Medical informatics and Telemedicine. Under the leadership of Dr.Sunil Shroff, eminent Nephrologist and President of MCSI, the fifth national conference on Medical informatics and telemedicine is scheduled to take place at Sri Ramchandra Medical College & Research Institute, Chennai on 19th-20th December, 2008.

“The conference (as in the past) will bring together decision makers, policy makers, practicing clinicians, healthcare educators and researchers, health administrators, health technologists and IT vendors.Meditel 2008 offers a platform to meet, interact and network with qualified specialists, users, buyers, healthcare providers, industry representatives, researchers and policy makers from India and abroad.

The event will showcase successful products in the Indian healthcare environment and discuss the challenges in their implementation. The use of ICT for ‘Health Education & Research’’ is the theme of this conference.

Meditel 2008 will feature an exhaustive conference program with more than 100 presentations along with workshops on a wide variety of topics to learn about what is latest in e-health and the likely future trends.”

I was a part of Meditel 2006 and can vouch for the quality of discussions held at Centre for Digital Health, Amrita institute of Medical Sciences, Kochi, Kerala.It proved extremely useful to me then and I expect a similar experience this year.

-Palliative care in Cancer-

Most People do not realize the importance of palliative care. in Cancer.

Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay or reverse progression of the disease itself or provide a cure. Palliative care is an interdisciplinary team approach, with a focus on comfort and quality of life rather than prolongation of life
or “cure” for a patient.

With better drugs and technology, we are dramatically improving the survival in cancer patients. New studies are carried out everyday to find new cures.Unfortunately, the research frequently focuses exclusively on survival as an endpoint, leaving surgeons with little information on an
intervention’s impact on QOL (Quality of Life).

There are multiple examples of problems that can affect the QOL for a patient facing the end of life. These can be categorized based on symptoms or systems in the body that are affected. Major symptoms include pain, dyspnea, anorexia, and depression. Related to body
systems, one can imagine a potential symptom related to each body system. Neurologic problems include fatigue, headache and other pain syndromes, and delirium. Pulmonary complications include dyspnea, fatigue, and immobility. Cardiac symptoms include shortness of breath, fatigue, and pain. Gastrointestinal problems include obstructions, diarrhea, nausea, vomiting, and anorexia. Musculoskeletal complications include fractures, functional loss, and pain. Epidermal problems mainly focus on wound problems, but also can include poor cosmesis and pain. Complications related to the hematologic system include infection and fatigue. Urologic problems include ureteral obstructions, bleeding, and pain. It is this compendium of problems that palliative care research focuses on, rather than increase in survival time or cure. We need more research to focus on these problems of the people who survive cancer.

There are many potential reasons for the lack of palliative care research. Many of them are related to ethical aspects of this research.There are also innate barriers, such as a lack of trained researchers and the challenges of subject recruitment.

For the original article, click here.

- Podcasting from Yale medical library-

Yale medical library published an interesting study-cum-project-cum-guide for use of screencasts and podcasts by medical learners.

The study finds many more off-campus users of the medical podcasts and videos than on-campus users. Not surprisingly, the cost benefits were very obvious. What i found particularly arresting was the suggestion of using only 1 to 3 minute long videos for teaching purposes. I would have thought that Ten minute videos would prove very effective. But apparently, yale students have difficulty viewing high quality content for more than a couple of minutes!!

See this slideshow for the complete report.

Screencasting and Podcasting: Experience of the Yale Medical Library

View SlideShare presentation or Upload your own. (tags: cla yale)

–Web 2.0 in medicine- A slideshow–

The impact of web 2.0 on medicine and healthcare

View SlideShare presentation or Upload your own. (tags: medicine medicine20)

This is a fine presentation on the use of Web 2.0 in Medicine.

It just puts into focus the importance and uses of Web 2.0 in today’s connected world of doctors,health care and patients on the same continuum.

Touching on Medicine 2.0

Image via Wikipedia

Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness | Eysenbach | Journal of Medical Internet Research

While it may be too early to come up with an absolute definition of Medicine 2.0 or Health 2.0, the figure below shows a suggested framework, created in the context of a call for papers for the purpose of scoping the Medicine 2.0 congress and this theme issue [5]. The program of the first Medicine 2.0 conference [6] also gives a good idea of what academics feel is relevant to the field. An explanation of why we chose the title “Medicine 2.0” over “Health 2.0” has been given elsewhere [4]; it suffices to say at this point that most authors do not necessarily see a significant difference between Health 2.0 and Medicine 2.0 [7]—if anything, Medicine 2.0 is the broader concept and umbrella term which includes consumer-directed “medicine” or Health 2.0.

According to the model depicted in this figure, five major aspects (ideas, themes) emerge from Web 2.0 in health, health care, medicine, and science, which will outlive the specific tools and services offered. These emerging and recurring themes are (as displayed in the center of Figure 1):

1) Social Networking,

2) Participation,

3) Apomediation,

4) Collaboration, and

5) Openness.

[view this figure] Figure 1. Medicine 2.0 Map (with some current exemplary applications and services)

While “Web 2.0”, “Medicine 2.0”, and “Health 2.0” are terms that should probably be avoided in academic discourse, any discussion and evaluations concerning the impact and effectiveness of Web 2.0 technologies should be framed around these themes. Each of the 5 themes will be considered in detail below.

Figure 1 also depicts the three main user groups of current Medicine 2.0 applications as a triangle: consumers/patients, health professionals, and biomedical researchers. While each of these user groups have received a different level of “formal” training, even end users (consumer, patients) can be seen as experts and—according to the Web 2.0 philosophy—their collective wisdom can and should be harnessed: “the health professional is an expert in identifying disease, while the patient is an expert in experiencing it” [8].

Current Medicine 2.0 applications can be situated somewhere in this triangle space, usually at one of the corners of the triangle, depending on which user group they are primarily targeting. However, the ideal Medicine 2.0 application would actually try to connect different user groups and foster collaboration between different user groups (for example, engaging the public in the biomedical research process), and thus move more towards the center of the triangle.

Putting it all together, the original definition of Medicine 2.0—as originally proposed in the context of soliciting submissions for the theme issue and the conference—was as follows [5]:

Medicine 2.0 applications, services and tools are Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies and/or semantic web and virtual-reality tools, to enable and facilitate specifically social networking, participation, apomediation, collaboration, and openness within and between these user groups.

Interestingly, Benjamin Hughes’ extensive literature review published in this issue concludes with a very similar definition [7].

There is however also a broader idea behind Medicine 2.0 or “second generation medicine”: the notion that healthcare systems need to move away from hospital-based medicine, focus on promoting health, provide healthcare in people’s own homes, and empower consumers to take responsibility for their own health—much in line with what others and I have previously written about the field of consumer health informatics [9] (of which many Medicine 2.0 applications are prime examples). Thus, in this broader sense, Medicine 2.0 also stands for a new, better health system, which emphasizes collaboration, participation, apomediation, and openness, as opposed to the traditional, hierarchical, closed structures within health care and medicine.

Original article here- http://www.jmir.org/2008/3/e22/

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