For Friday Foolery a picked up this fragment from the science comedianBrian Malow. He performed in the session Science Laughs at Wonderfest 2009, The San Francisco Bay Area Festival of Science. The complete video can be viewed at Fora.tv (2009/11/08).
I like the virus/bacteria part, but it took a while for me to understand that ’staff’ should be spelled as ’staph’.
Methodological Search Filters can help to narrow down a search by enriching for studies with a certain study design or methodology. PubMed has build-in methodological filters, the so called Clinical Queries for domains (like therapy and diagnosis) and for evidence based papers (like the“Systematic Review subset” in Pubmed). These searches are often useful to quickly find evidence on a topic or to perform a CAT (Critical Appraised Topic). More exhaustive searches require broader filters not incorporated in PubMed. (See Search Filters. 1. An Introduction.).
The Redesign of PubMed has made it more difficult to apply Clinical Queries after a search has been optimized. You can still go directly to the clinical queries (on the front page) and fill in some terms, but we rather advise to build the strategy first, check the terms and combine your search with filters afterwards.
Suppose you would like to find out whether spironolactone effectively reduces hirsutism in a female with PCOS (see 10+ 1 Pubmed Tips for Residents and their Instructors, Tip 9). You first check that the main concepts hirsutism and spironactone are o.k. (i.e. they map automatically with the correct MeSH). Applying the clinical queries at this stage would require you to scroll down the page each time you use them.
Instead you can use filters in My NCBI for that purpose. My NCBI is your (free) personal space for saving searches, results, PubMed preferences, for creating automatic email alerts and for creating Search Filters.
The My NCBI-option is at the upper right of the PubMed page. You first have to create a free account.
To activate or create filters, go to[1] My NCBI and click on [2] Search Filters.
Since our purpose is to make filters for PubMed, choose[3] PubMed from the list of NCBI-databases.
Under Frequently Requested Filters you find the most popular Limit options. You can choose any of the optional filters for future use. This works faster than searching for the appropriate limit each time. You can for instance use the filter for humans to exclude animals studies.
The Filters we are going to use are under “Browse Filters”, Subcategory Properties….
….. under Clinical Queries (Domains, i.e. therapy) and Subsets (Systematic Review Filters)
You can choose any filter you like. I choose the Systematic Review Filter (under Subsets) and the Therapy/Narrow Filter under Clinical Queries.
In addition you can add custom filters. For instance you might want to add a sensitive Cochrane RCT filter, if you perform broad searches. Click Custom Filters, give the filter a name and copy/paste the search string you want to use as filter.
Control via “Run Filter” if the Filter works (the number of hits are shown) and SAVE the filter.
Next you have to activate the filters you want to use. Note there is a limit of five filters (including custom filters) that can be selected and listed in My Filters.
Under My Filters you now see the Filters you have chosen or created.
From now on I can use these filters to limit my search. So lets go to my original search in “Advanced Search”. Unfiltered, search #3 (hirsutism AND spironolactone) has 197 hits.
When you click on the number of hits you arrive at the results page.
At the right are the filters with the number of results of your search combined with these filters (between brackets).
When you click at the Systematic Reviews link you see the 11 results, most of them very relevant. Filters (except the Custom Filters) can be appended to the search (and thus saved) by clicking the yellow + button.
Each time you do a search (and you’re logged in into My NCBI) the filtered results are automatically shown at the right.
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Clinical Queries zijn vaak handig als je evidence zoekt of een CAT (Critical Appraised Topic) maakt. In de nieuwe versie van PubMed zijn de Clinical Queries echter moeilijker te vinden. Daarom is het handig om bepaalde ‘Clinical Queries’ op te nemen in ‘My NCBI’. Deze queries bevinden zich onder Browse Filters (mogelijkheid onder Search Filters)
Het is ook mogelijk speciale zoekfilters te creëeren, zoals b.v. het Cochrane highly sensitive filter voor RCT’s. Dit kan onder Custom Filters.
Controleer wel via ‘Run Filter” of het filter werkt en sla het daarna op.
Daarna moet je het filter nog activeren door het hokje aan te vinken. Dus je zou alle filters van de ‘Clinical study category’ kunnen opnemen en deze afhankelijk van het domein van de vraag kunnen activeren.
Zo heb je altijd alle filters bij de hand. De resultaten worden automatisch getoond (aan de rechterkant.
Last Thanksgiving weekend, many of us bloggers participated in the first documented “blog rally” to promote Engage With Grace – a movement aimed at having all of us understand and communicate our end-of-life wishes.
It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with a weekend when most of us are with the very people with whom we should be having these tough conversations – our closest friends and family.
Our original mission – to get more and more people talking about their end of life wishes – hasn’t changed. But it’s been quite a year – so we thought this holiday, we’d try something different.
A bit of levity.
At the heart of Engage With Grace are five questions designed to get the conversation started. We’ve included them at the end of this post. They’re not easy questions, but they are important.
To help ease us into these tough questions, and in the spirit of the season, we thought we’d start with five parallel questions that ARE pretty easy to answer:
Silly? Maybe. But it underscores how having a template like this – just five questions in plain, simple language – can deflate some of the complexity, formality and even misnomers that have sometimes surrounded the end-of-life discussion.
So with that, we’ve included the five questions from Engage With Grace below. Think about them, document them, share them.
Over the past year there’s been a lot of discussion around end of life. And we’ve been fortunate to hear a lot of the more uplifting stories, as folks have used these five questions to initiate the conversation.
One man shared how surprised he was to learn that his wife’s preferences were not what he expected. Befitting this holiday, The One Slide now stands sentry on their fridge.
Wishing you and yours a holiday that’s fulfilling in all the right ways.
The next Grand Rounds is hosted by How To Cope With Pain and, not surprisingly, the main theme will therefore be pain. Now, I had a personal story in mind on the downside of testing, but I didn’t have a good title that fit the theme. Till, this Saturday when I a saw a perfect headline in the Los Angeles Times (Nov 21th), reading:
Cancer screening: What could it hurt? A lot, actually
It is a very thoughtful article showing the downside of screening. It was prompted by “the furor over this week’s recommendation from the U.S. Preventive Services Task Force that most women wait until age 50 to start routine mammograms, and then get them only every other year.” (also see kaleidoscope 2009- wk47).
In 1984, Japan began screening the urine of 6-month-old infants for neuroblastoma, the most common type of solid tumor in young children. The test was simple and could show signs of cancer long before clinical symptoms arose.
Hundreds of infants went through the ordeal of diagnosis and treatment, but it didn’t reduce the number of tumors, including deadly ones, found later. Almost none of the tumors caught by screening turned out to be dangerous — and more of the screened children died from complications of surgery and chemotherapy than from the cancer itself.
In 2004, health officials ended the program.
The article further describes the potential downsides of current cancer screening protocols, including breast cancer screening.
But finding cancers that respond to early treatment is only one of the potential outcomes from a screening test. Many tests produce false positives, prompting additional tests that can be invasive, expensive, time-consuming and anxiety-inducing.(……)
Other screening tests produce false negatives, giving patients and their doctors the incorrect impression that they have nothing to worry about.
Some detect aggressive cancers whose outcomes aren’t improved by early detection.
And some identify small cancers that grow so slowly they’d never compromise a patient’s health. Many would even go away on their own.
All true but the problem is that people see it as their right to be screened (Will Women in Their 40s Be Denied etc). Cancer survivors are furious about the new breast cancer screening guidelines, they think decisions are made on political grounds and/or fear Medicare will no longer cover screening at younger age.
Why people are upset about the softened screening recommendations is because cancer is a frightening and deadly disease and because (as the Los Angeles Times explains so well) it’s easy to identify cancer survivors whose tumors were caught by screening, but it’s nearly impossible to put a face on the woman or man who is hurt by over-screening.
The first time I heard about the downside of screening was in 2004, when I attended a meeting for Conn patients to write an article for the patients association NVACP (see page 11-16, Dutch). Prof. Kievit, a surgeon and professor in decision analysis said:
“Imaging techniques (CT-scan or MRI) should only be applied if the stature test is positive and the aldosterone blood levels proven to be abnormally high. This is important because people often have benign nodules. Innocent nodules (incidentalomas) can obscure the diagnosis, worry the patient or even lead to unnecessary interventions. Furthermore it is inefficient to randomly subject people to all kind of tests. And please do not follow the current US trend to ask a CT-scan for your birthday!
That the balance of harm and benefit of diagnostic tests and screening can dip the wrong way can be best understood when you experience it yourself.
from: Wikipedia
During my last pregnancy my daughter was diagnosed with a mild prenatal hydronephrosis during routine pregnancy ultrasound. Hydronephrosis is distension and dilation of the renal pelvis, usually caused by obstruction of the free flow of urine from the kidney. Since this can lead to progressive atrophy of the kidney, my little girl also had to undergo several tests to check the function of the kidneys and the cause of this anomaly. For one of those tests she had to be injected with radioactive isotopes in the catacombs of another hospital. But everything seemed o.k.: the anatomy (no obstruction) and the kidney functions. It should also be stressed that the dilatation was near-normal and didn’t worsen. Nonetheless, because of complications often seen with children with severe dilatation my daughter had to take daily antibiotics as a preventive measure. We had to regularly visit the polyclinics for an ultrasound and urine testing (to exclude infection and resistance). After a year it was decided to discontinue the antibiotic treatment. Follow-up was not needed. Later a pediatric urologist told us that the guidelines had been changed: preventive antibiotic treatment was no longer required in case of mild hydronephrosis with no underlying cause.
My daughter developed asthma at the age of 7. Both she and her sister had atopic eczema, a known predicting factor for asthma, when they were toddlers. In line with the hygiene-theory, that states that a lack of early childhood exposure to infectious agents, increases susceptibility to allergic diseases, I often wondered whether 1 year daily antibiotic treatment wasn’t the final trigger for my daughter’s asthma. Indeed @Allergy (Ves Dimov) recently twittered about a study in J Allergy Clin Immunol that showed an association between antibiotic use in the first year of life and current symptoms of asthma in children 6 and 7 years old. A Systematic Review of observational studies came to the same conclusion: “Exposure to at least one course of antibiotics in the first year of life appears to be a risk factor for the development of childhood asthma.” These studies had some limitations, and don’t prove there is a causal relationship between antibiotic treatment and asthma, but they do fuel my suspicion.
In any case, although prenatal diagnosis of hydronephrosis may help to prevent later development of serious kidney disease in children with real malformations, it only resulted in “harm” in our case. Unnecessary testing (all results negative), unnecessary polyclinic visits, worries (that stayed until she was 9, when we visited the pediatric urologist to exclude an UTI, because you never know..)), unnecessary antibiotic treatment and -perhaps- the triggering of asthma. Looking back, and knowing what I know now, I wished the somewhat dilated renal pelvis had never been observed.
Last Friday I was at a lottery offered by my Sports Club. The last 2 prices were mystery prices: A total body scan of 1000 Euros each. I heard a lot of “Aaahs” and “Oooohs”. But I whispered “not for me“. The women next to me turned their heads, looked at me perplexed with their eyes blanked. Of course it is difficult to understand why one would refuse such a price, because “if screening doesn’t help, it won’t harm either”.
This week I would like to put several Dutch people in the limelight.
All these people have in common that they twitter mainly in English about scientific and/or library 2.0 subjects. And they are all nice.
@digicmb (medlib, geek, NL, **) and @DrShock (doctor, psychi, NL, **) were already on my #FF-list
@digicmb(Guus van den Brekel) was on Twitter long before I gave it a try. He knows a lot about Second Life, Web 2.0 Tools (especially all kinds of widgets and Netvibes) and is always willing to share information. A must follow for librarians. His blog is http://digicmb.blogspot.com/. The Google Wave directory of helpful waves! is a recent post that I liked.
I already knew @DrShock as a blogger. DrShock is a Dutch psychiatrist working in a University hospital. His specialty in psychiatry is the treatment of depression. His blog (http://www.shockmd.com/) is regularly mentioned on this blog. It has a beautiful lay-out with a broad coverage of subjects. DrShock even regularly participates in the Medlibs Round and will be a future host of this Medical Librarian blog carnival as well.
Another Dutch psychiatrist, with a similarly well chosen name: @TheSofa. Georg Fritz is only recently on Twitter, but had interesting Tweets right from the start. He also started a posterous account: georgfritz’s posterous. I like the The November poem I by Thomas Hood, that starts like this: No sun–no moon! No morn–no noon! No dawn–no dusk–no proper time of day– No sky–no earthly view– No distance looking blue–….
No wonder people get depressed at this time of year.
Also very interesting are the tweets of @Nutrigenomics, Professor in Nutrigenomics, Wageningen University and Director of NL Nutrigenomics Centre. Main emphasis of tweets is on genetics, nutrition, science and health. The link at his Twitter account goes to the Nutrition, Metabolism Genomics Groupat the Wageningen University.
Last week I first ‘met’ @Beatis on Twitter. She is still not sure about the value of Twitter. I hope she will stay tweeting, because her tweets -that can be best described as (moderately) skeptic- are certainly valuable. She co-authors the (english-language) Anaximperator blog. The purpose of this blog is to warn against alternative medicine and alternative medicine for cancer in particular.
Kaleidoscope is a new series, with a “kaleidoscope” of facts, findings, views and news gathered over the last 1-2 weeks.
Most items originate from Twitter, my Google Reader (RSS) and sometimes real articles (yeah!).
I read a lot, I bookmark a lot, but only some of those things end op in a post. Since tweets have a half-life of less than a week, I thought it would be nice to safeguard some of the tweets in a post. For me to keep, for you to read.
I don’t have the time and the discipline to post daily about health news and social media as Ves Dimov does. It looks more like the compilation at blogs of dr Shock’s (see example), dr Batesshout-outs, Health Highlights of Highlight HEALTH and Rachel Walden’sWomens health News Round-ups, but less on one subject and less structured. It will just be a mix of old and new, Social Media and science, just a kaleidoscope. Or a potpourri if you like.
I don’t know if this kaleidoscope will live a long live. I already wrote 2345 6 editions, but didn’t have the time to finish them. Well, we will see, just enjoy this one.
Ooh and the beautiful kaleidoscope is made by RevBean and is called: Eyeballs divide like cells. Looks very much like the eyeball-bubblewrap of a previous post but that is thus coincidence. Here is the link (Flickr, CC)
Medical Grand Rounds
Louise Norris at Colorado Health Insurance Insider is this week’s host of Grand Rounds.(see here). There are many interesting posts again. As a mother of two teens I especially liked the insight Nancy Brown of Teen Health 411 brings us into what teens want when it comes to their relationships with their parents and the “would you rather…?” story that Amy Tenderich of Diabetes Mine shares with us. The punch line is great. Her 9 year old melts my heart.
At InsureBlog’sHank Stern brings us an article about a British hospital that will no longer admit expectant mothers with a BMI of more than 34, because the hospital’s labor and delivery unit is not equipped to handle complicated births. Hank concludes: “Fear not, though, portly preggies have to travel but 20 miles to the next closest facility. Assuming, of course, that they can make it that far when contractions are minutes apart.”
Dr Charles of the The Examining Room wrote an in depth article about a cheerleader who was supposedly stricken with dystonia following a seasonal flu vaccine in August. Dr Charles not only highlights why (specialists) think it is not dystonia, but gives also background information about the efficacy of vaccins.
Recent editions of the Grand Rounds were at CREGRL, flight nurse(link), NonClinicalJobs (link) andCodeblog, tales of a nurse (link). You can always find previous and upcoming hosts at the Grand Rounds Archive at Blogborygmi.
Breast cancer screening
The update of the 2002 USPSTF recommendation statement on screening for breast cancer in the general population, published in the November issue of The Annals of Internal Medicine has led to heated discussions in the mainstream media (i.e. New York Times and MedPage Today). Based on current evidence, partly based on 2 other articles in the same journal (comparison screening schedules and an systematic review) the guidelines advise scaling back of the screening. The USPSTF recommends:
against routine screening mammography in women aged 40 to 49 years
against routine screening mammography of women 75 years or older.
biennial (instead of annual) screening mammography for women between the ages of 50 and 74 years.
against teaching breast self-examination (BSE).
against either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities.
The two articles published in Ann Intern Med add to the evidence that the propagation of breast cancer self exam doesn’t save lives (see Cochrane review discussed in a previous post) and that the benefits of routine mammography in the young (<50) or old (>75) do not outweigh the harm (also covered by a Cochrane review before). Indeed, as put forward by Gary Schwitzer at Schwitzer health news blogthis is NOT a new debate. He refers to Slate who republishes a five-year old piece of Amanda Schaffer that does a good job of explaining the potential harms of screening. However it is difficult for women (and some doctors) to understand that “When it comes to cancer screening, more isn’t always better.” Indeed -as Kevin Pho at Kevin MD states, the question is whether “patients will accept the new, evidence-based, breast cancer screening guidelines”.
In the Netherlands it is already practice to start biannual routine mammography at the age of 50. The official breast cancer screening site of the RIVMeven states that the US is now going to follow the Dutch guidelines (one of assessed guidelines in one the Ann Intern Med papers is Dutch). But people still find the long established guidelines difficult to accept: coincidentally I saw tweets today asking to sign a petition to advance the age of screening ‘because breast cancer is more and more frequently observed at young age…(??)’ Young, well educated, women are very willing to sign…
No time to read the full articles, but interested to know more, then listen to the podcast of this Ann Intern Med edition:
Systematic Reviews, pharma sponsored trials and other publishing news
Cochrane reviews are regarded as scientifically rigorous, yet a review’s time to publication can be affected by factors such as the statistical significance of the findings. A study published in Open Medicine examined the factors associated with the time to publication of Cochrane reviews. A change in authors and updated reviews were predictive factors, but the favorability of the results was not.
Roy Poses of the Health Care Renewal Blog starts this blogpost as follows: “Woe to those of us who have been advocates for evidence-based medicine”. He mainly refers to a study published in the NEJM, that identified selective outcome reporting for trials of off-label use of gabapentin: for 8 of the 12 published trials, there was a disagreement between the definition of the primary outcome in the protocol and that in the published report. This seriously threatens the validity of evidence for the effectiveness of off-label interventions. Roy was surprised that the article didn’t generate much media attention. The reason may be that we have been overwhelmed by manipulation of data, ghostwriting and by the fact that pharma-sponsored trials rarely produce results that are unfavorable to the companies’ product (see previous posts about Ghostwriting (Merck/Elsevier, Conflict of Interest in Cancer Studies and David Tovey about Cochrane Reviews). At least two authors of the NEJM review (Bero and Dickersin) have repeatedly this to be the case [e.g. see here for an overview, and papers of Lisa Bero]. It is some relief that at least 3 of the 4 NEJM authors are also members of the Cochrane Collaboration. Indirectly better control of reporting, i.e. by clinical trials registries, can improve the reliability of pharma sponsored trials and thus systematic reviews summarizing them. As a matter of fact Cochrane authors always have to check these registries.
The open access nature of PLOS itself gets out of hand: they even peer-review T-shirts (according to Bora Zivkovic of a Blog around the Clock, see here)
Other Health & Science News:
Medline Plussummarizes an article in the Journal of Nutrition, that states that Selenium supplements, may pose a heart risk.
Even Folic Acid and vitamin B12, when taken in large doses, have been reported to Increase Cancer Risk (WebMD)
Luckily WebMD also reports that dark chocolate seems to help against stress, that is it reduced stress hormones in the blood. However @evidencematters and @NHSChoicescast doubt on that : “Chocolate cuts stress, says newspaper. Does the study really say that? And who paid for the study?…”
Scientists made the unexpected discovery (published in Molecular Cell)that BRAF, which is linked to around 70 per cent of melanomas and seven per cent of all cancers, is in fact controlled by a gene from the same RAF family called CRAF – which has also been linked to the disease. For the first time it is shown “how two genes from the same ‘family’ can interact with each other to stop cancer in its tracks” (Source: Info Cancer Research UK)
For the first time, scientists have successfully used exome sequencing to quickly discover a previously unknown gene responsible for Miller syndrome, a rare disorder. The finding demonstrates the usefulness of exome sequencing in studying rare genetic disorders. The exome is enriched for coding (thus functional) DNA, it is only 1% of the total DNA, but contains 85% of the mutations (Published in Nature Genetics, source: PhysOrg.com)
Web 2.0
For information regarding the FDA hearings on internet and social media see #FDASM: http://www.fdasm.com.
Read Write Web summarizes the new numbers released by analytics firm Postrank that indicate that reader engagement with blogs has changed dramatically over the last three years, primarily because of the rise of online social networks.
Twitter has began to relaunch the new retweet feature, although not without controversy. What do you think about the newest feature?
And Finally: Top 100 tools for learning, compiled by Jane Hart from the contributions of 278 learning professionals worldwide. You can see the lists here (HT: http://blogs.netedu.info/?p=1005)
The web 2.0 part is relatively short, but it is time to conclude this edition. Till next time!
Last week I was invited to speak at the NVB-congress, the Dutch society for librarians and information specialists. I replaced Josje Calff in the session “the professional”, chaired by Bram Donkers of the magazine InformatieProfessional. Other sessions were: “the client”, “the technique” and “the connection”. (see program)
It was a very successful meeting, with Andrew Keenand Bas Haring in the plenary session. I understand from tweets and blogposts that @eppovannispen en @lykle who were in parallel sessions were especially interesting.
Some of the (Dutch) blogposts (Not about my presentation….pfew) are:
I promised to upload my presentation to Slideshare. And here it is.
Some slides are different from the original. First, Slideshare doesn’t allow animation, (so slides have to be added to get a similar effect), second I realized later that the article and search I showed in Ede were not yet published, so I put “top secret” in front of it.
The title refers to a Dutch book and film: “Help de dokter verzuipt” (“Help the doctor is drowning”).
Slides 2-4: NVB-tracks; why I couldn’t discuss “the professional” without explaining the changes with which the medical profession is confronted.
Slides 5-8: Clients of a medical librarian (dependent on where he/she works).
Slides 9-38: Changes to the medical profession (less time, opinion-based medicine gradually replaced by evidence based medicine, information overload, many sources, information literacy)
Slides 39-66: How medical librarians can help (‘electronic’ collection accessible from home, study landscape for medical students, less emphasis on books, up to date with alerts (email, RSS, netvibes), portals (i.e. for evidence based searching), education (i.e. courses, computer workshops, e-learning), active participation in curriculum, helping with searches or performing them).
Slides 67-68: Summary (Potential)
Slide 69: Barriers/Risks: Money, support (management, contact persons at the departments/in the curriculum), doctors like to do it theirselves (it looks easy), you have to find a way to reach them, training medical information specialists.
The MedLib’s Round, the monthly blog carnival that highlights some of the best writing on medical librarianship, encompassing all stages in the publication and dissemination of medical information: writing, publishing, searching, citing, managing and social networking is up at Highlight Health(link).
The theme of this incredible 8th edition is: Finding Credible Health Information Online.
Walter Jessen introduces the round as follows:
There’s a revolution occurring on the Web: those “authoritative” articles written on traditional, static websites are being replaced with blogs, wikis and online social networks. In the sphere of health, medicine and information technology, this “real-time Web” consists of many who are experts in the field; these are their posts listed below.
In the digital age, these are the characteristics of new media: recent, relevant, reachable and reliable.
Subjects: “Searching the Web for health information”, “Biomedical research”, “Web 2.0 tools”, “PubMed Redesigned” and “Social media and participatory medicine” with contributions of Women’s Health News, Our Bodies Our Blog [@rachel_w]* Emerging Technologies Librarian [@pfanderson] Musings of a Distractible Mind [@doc_rob] Laika’s MedLibLog [@ericrumsey, Janet Wale, @Laikas], Significant Science [@hleman], Websearch Guide Internet News [Gwen Harris], Alisha764’s Blog [@alisha764] Next Generation Science [@NextGenScience], Dr Shock MD Ph [@DrShock], Life in the Fast Lane [@sandnsurf], Knowledge beyond words [@novoseek on Twitter], Eagle Dawg Blog [@eagledawg], The Search Principle blog [@giustini], Krafty Librarian [@Krafty], Dose of Digital [@jonmrich], e-Patients.net [@SusannahFox] and Highlight HEALTH [@HighlightHEALTH].
Walter Jessen [wjjessen] concluded the blog carnival with a great presentation of Kevin Clauson [@kevinclauson] on the role of Facebook and Twitter in pharmacy and the development of participatory medicine. Since I intended to show this presentation anyway, I might as well place it here :
Apparently it is, at least according to a study published in the BMJ in 1993 [1].
This retrospective study comparing driving and shopping patterns and accidents shows that Friday 13th is unlucky for some. Despite that there were consistently and significantly fewer vehicles on the southern section of the M25 on Friday the 13th compared with Friday the 6th, the admissions due to transport accidents were significantly increased on Friday 13th (total 65 v 45; p < 0.05). Since the risk of hospital admission as a result of a transport accident may be increased by as much as 52%, staying at home is recommended by the authors.
In a related article (PubMed) in the Am J Psychiatry (2002), deaths from Finnish traffic accidents on Friday the 13th were compared with those on other Fridays. Here a difference was found between men and women. In men, the adjusted risk ratio for dying on Friday the 13th, compared with other Fridays, was 1.02, (no difference) but for women, it was 1.63. An estimated 38% of traffic deaths involving women on this day were attributable to Friday the 13th itself.
Therefore again this author concludes that Friday the 13th may be a dangerous day, but only for women. The author thinks this is largely because of anxiety from superstition. Although the risk of traffic deaths on this date could be reduced by one-third, the absolute gain would remain very small: only one death per 5 million person-days.
Other Finnish researchers reinvestigated this finding, but they also looked at the injury accident database, because this database contains much more data than the fatality database. They reasoned that if there was a Friday-the-13th effect by impaired psychic and psychomotor functioning due to more frequent anxiety among women, it should also appear in the number of injury crashes. They found no consistent evidence for females having more road traffic crashes on Fridays the 13th, based on deaths or road accident statistics. Still, since an effect of superstition related anxiety on accident risk can not be excluded, the authors conclude that people who are anxious of “Black Friday” may stay home, or at least avoid driving a car.
Well at least you now know what scientific research says about Friday the 13th, or uuh don’t you?
At least, females suffering from Paraskevidekatriaphobia or even Triskaidekaphobia should better stay at home. You know, just in case…
In short, FollowFriday is a way to recommend a few people to your Twitter-followers. For at least 2 reasons: to acknowledge those favorite tweeters and make it easier for your followers to find new interesting people.
However, many people don’t use the FollowFriday correctly. For instance, they spend several tweets just mentioning dozens of @people and they repeat the tweets (retweet) about each recommendation they get @themselves. That is annoying for people seeing these tweets appearing in their timeline.
In this FollowFriday post I suggested some Twitter Etiquette Rules as well as some alternatives for the FollowFriday approach.
Now there is another alternative, which can either be used alone or as an adjunct to the normal FollowFriday-tweets:
Twitterlists!
The Twitter List feature is designed to make following and suggesting groups of tweeters easier. Everyone on Twitter can create up to 20 lists with a maximum of 500 Twitter people each. Others can follow these lists as well. So instead of FollowFridays you could construct lists of your favorite Twitter people for others to follow. There is one disadvantage of this approach: context is lost. You can only put people on a list without any further explanation why. Of course, you can create separate lists of categories of people, in my case librarians, doctors and funny people for instance, so others have an idea what to expect.
Some people think Twitterlists make FollowFridays obsolete. However Twitterlists and FollowFridays could reinforce each other. At least that’s what I will try using the following approach.
I will construct a FollowFriday Twitter list on basis of my FollowFriday-tweets. They provide the context. Because Tweets get lost, I will gather those tweets on a separate page, so you can always find my elaborated FF-recommendations there.
For Twitter-newcomers, who know me, but find it difficult to find interesting people to follow, this may be a useful starting point.
In selective cases I also plan to write a #FF post to put someone in the limelight. I intend to do the same with bloggers.
By the way I only include people with useful tweets on the lists, so people with great blogs but with not so interesting or very infrequent tweets won’t be included.
As time goes, I may also prune the list, because the number or quality of the tweets or my preference may change.
What is a good tweet? That is personal, but I think that people should be original, helpful, social and up to date and provide good information (with links) .
The Following people are included on my FF-list (listed chronologically according my tweet-timeline)
** means that I often have a chitchat or social talk with that person and/or that he/she is very helpful).
Guest author: Janet Wale member of the Cochrane Consumer Network
People are still struggling with evidence or modern medicine clinicians, patients, health consumers, carers and the public alike. Part of this is because we always thought medicine was based on quality research, or evidence. It is not only that. For evidence to be used most effectively in healthcare systems researchers, clinicians and the existing or potential patients and carers have to communicate and resonate with each other – to share knowledge and responsibilities both in developing the evidence and in individual decision making. On the broader population level, this may include consultation but is best achieved by developing partnerships.
The Cochrane Collaboration develops a large number of the published systematic reviews of best evidence on healthcare interventions, available electronically on The Cochrane Library. Systematic reviews are integral to the collation of evidence to inform clinical practice guidelines. They are also an integral part of health technology assessments, where the cost-effectiveness of healthcare interventions is determined for a particular health system.
With the availability of the Internet we are able to readily share information. We are also acutely aware of disadvantage for many of the Worlds populations. What this has meant is pooled efforts. Now we have not only the World Health Organization but also The Cochrane Collaboration, Guidelines International Network, and Health Technology Assessment International. What is common among these organizations? They involve the users of health care, including patients, consumers and carers. The latter three organizations have a formal consumer/patient and citizen group that informs their work. In this way we work to make the evidence relevant, accessible and being used. We all have to be discerning whatever knowledge we are given and apply it to ourselves.
Guest author: Eric Rumsey (@ericrumsey on Twitter) Librarian and Web Developer at University of Iowa
Creater and Keeper of Hardin MD
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When looking for skin disease pictures on the Web, the first step is to search for the specific disease terms of interest in Google Image Search. You will likely find something, but don’t assume that it comes close to being everything — Very likely it doesn’t! In my experience, it will have somewhere in the range of 10-30% of everything on the Web. In particular, it will not have images from what I consider to be the single most comprehensive, reliable site for skin disease pictures — DermNet.com, by Alan N. Binnick & Thomas P. Habif, Dartmouth Medical School.
Though Dermnet.com is a large site, with high-quality pictures, it does not appear in Google Image Search, apparently because the tagging/metadata is so sparse. Indeed, the pictures on the site are virtually without any accompanying text. They are classed by disease, but not by any other characteristics, e.g. age, gender, or anatomical region.
A relatively small subset of the images in Dermnet.com are included in Hardin MD, where the tagging/metadata is more complete, making them easier to search. These images are included by special arrangement with people at Dermnet, who have given us permission to include them in Hardin MD.
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