NHS Choices - Behind the Headlines: party at the Hunterian, RCS

A couple of nights ago I wangled a last minute ticket to an event at the Hunterian Museum celebrating NHS Choices' Behind the Headlines which has been running for five years now. Originally it was to have been a going home and washing my hair sort of evening, but one colleague had to drop out and the invitation was extended to me. I turned up a bit casual whereas everyone else was froofed up to the nines but that's what happens with the last minuteness...

Behind the Headlines is a wonderful service - it's like having on-call nerds going through media reports of a health story, and going through the original published article as well and putting it in context. Extremely helpful and I use the service a lot, in terms of forwarding people towards someone else's take on something good or bad that's got into the newspapers or online.

The evening was for science communicators - largely journalists, and communicators from medical research and other science/health-promoting charities (Diabetes UK, Cancer Research UK, Wellcome, AMRC, Prostate Cancer charity - didn't get to meet them though and Sense About Science).

I arrived early enough to wander around and have a good look at the fascinating and gruesome items on display in the museum. Lovely old glass jars, many oval shaped rather than round which was new to me, most of them had a thick black band round the top which presumably sealed the lid to the jar. There were plenty of bits and pieces of pickled people and animals, including an eerily lifelike part of a child's face. After death the tissue had been injected with a dye to bring out the blood vessels and I've never seen anything quite like it - but for the fact that it was obviously an incomplete face it looked just like a child with its eyes shut. There was also the Irish giant, the skeleton of someone who reached 7ft7in and umpteen pickled foetuses and stillborn babies. Lots of bits of chickens, rats, tortoises, water voles etc. too.

While there I also got chatting to Dr Alicia White, of Bazian, who wrote a series of suggested 'how not to get the wrong idea from stuff written in some newspapers' which Ben Goldacre helpfully posted on his blog. It also occurred to me that it was Ben's blog that introduced me to Behind the Headlines in the first place (and it was his blog that introduced me to Sense About Science) and that I've derived an enormous benefit from Ben's social media output (not just 'continuing professional development' on critical appraisal but other fun stuff like Ian Helliwell's podcast series on early analog / electronic music) - so hooray for Ben*.

After a series of refills and beautifully presented canapes Bruce Keogh and Muir Gray spoke about how the service had begun and what it had achieved. There was a little bit of chat about DUETS, set up by Iain Chalmers, which attempts to capture what we know we don't know about the effects of treatments - there are a few in the database relating to diabetes. Gray mentioned his concept of the 'third revolution' of medicine, this time it's knowledge, and the importance of the web in making information accessible (citizens, knowledge, IT and the internet). However trusted sources are crucial and that's really the role that BtH plays - it's aimed at a wide readership and is used by the public too (it has a large hit rate, I forget the exact figure but pretty impressive). Apparently one thing they were looking at in its early days was the feasibility of having something written very soon after a story broke, in that they were thinking that nerds in Australia might write the content, taking advantage of the hemisphere timing difference! - however Bazian cover about two stories every day.

*Incidentally I suppose this post is also a #ff follow Friday for @bengoldacre - although I expect that almost everyone reading this will already be following him. He tweets like Tom Hulce (Wolfie) in Amadeus, but blogs like Mozart ;-)

See also
London Museums of Health & Medicine - http://www.medicalmuseums.org/
What is Behind the Headlines? (Sir Muir Gray's biography) - http://www.nhs.uk/news/pages/sirmuirgraysbiography.aspx

Paper clips in the service of medical science

I don't usually PubMedGoogle (PMoogle?) for the words paperclips or paper clips. Today I did, after reading a colleague's paper on 'resilience markers framework' (http://www.cs.ucl.ac.uk/staff/d.furniss/Documents/ResilienceMarkersFramework_rev2.pdf) which briefly featured a mildly heroic role for a paperclip.

The paper clip (is it one word or two?) was used to mark an important page in the procedural instructions that would be needed quickly to bring a nuclear power plant under control if it went a bit cheeky. The paper clip's use was a small example indicating that the power plant team was building resilience into their system to help them handle unexpected problems or errors.

When I read this I wondered if there were other ways in which paper clips have gone beyond the call of duty / remit to help humanity.

Yes.

Abstracts or full article below unless otherwise stated.

Retraction of Oedematous Eyelids with Paper-Clips
Leo H-H Cheng and Pragia Kumar
Ann R Coll Surg Engl. 2008 April; 90(3): 253.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430453/
Warning: this website has a thumbnail black and white image of paperclips being used to hold open eyelids - it's not bad, but I don't know how squeamish people reading might be.

Establishing a reliable protocol to measure tongue sensation.
Boliek CA, Rieger JM, Li SY, Mohamed Z, Kickham J, Amundsen K.
J Oral Rehabil. 2007 Jun;34(6):433-41.
http://www.ncbi.nlm.nih.gov/pubmed/17518978

Paperclips for ear lobule repair.
Koshy O.
J Plast Reconstr Aesthet Surg. 2006;59(9):1008-9. Epub 2006 Mar 9.
http://www.ncbi.nlm.nih.gov/pubmed/16920599
(no abstract available)

Airways, paper clips, and nasogastric tubes.
Luke SJ.
Anesth Analg. 1995 Jul;81(1):208-9.
http://www.anesthesia-analgesia.org/content/81/1/208.long

The literature doesn't have as much to say on Post It notes.

EDIT 22 July 2010 afternoon: A colleague, similarly intrigued by the hidden role of paper clips, sent me a copy of an article from the Law Library. I'll be reading that on the train home, along with @jackofkent's blogpost on the recent Scientology kerfuffle.

Something Little and Shiny on the Judicial Stage: The Paper Clip
Jay W. Stein (p.323)
Law Library Journal Volume 86 Number 2 1994
http://bubl.ac.uk/archive/journals/llj/v86n0294.htm
http://www.guardian.co.uk/education/2009/may/19/paper-clips-legal-appearances

PACT data - very small blogpost for @Tiamat_R and @amcunningham

Prescribing Analysis and Cost Tabulation (PACT data), 2008, for the four nations. Presumably there's 2009 data but this is what I came across.

General prescribing information
NHS Information Centre for Health and Social Care.
PACT Data for England.
http://www.ic.nhs.uk/default.asp?sID=1172577414129&sPublicationID=1239718155461&sDocID=4973

NHS Northern Ireland.
PACT Data for Northern Ireland.
http://www.centralservicesagency.com/files/statistics/file/PCT2008.xls

NHS Scotland.
PACT Data for Scotland.
http://www.isdscotland.org/isd/servlet/FileBuffer?namedFile=PCA%202008.xls

NHS Wales.
PACT Data for Wales.
http://www.wales.nhs.uk/sites3/docopen.cfm?orgid=428&id=117449&A03B1E2D-1143-E756-5CD9AAFEAC8087BD

Diabetes-specific prescribing data
Prescribing for Diabetes in England: Supplement - January 2002 to March 2009
Publication date September 15, 2009
http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/prescriptions/prescribing-for-diabetes-in-england:-supplement--january-2002-to-march-2009
which is a supplement taking account of data up to March 2009 and published in September 2009.

Prescribing for Diabetes in England – An Update 2002-2008
An analysis of volume, expenditure and trends.
Publication date June 2009
http://www.yhpho.org.uk/resource/view.aspx?RID=9711

Prescribing for Diabetes in England
An analysis of volume, expenditure and trends
November 2007
http://www.yhpho.org.uk/resource/view.aspx?RID=45983

Prescribing for Diabetes in England - Interactive Map
(Revised version June 2009)
http://www.yhpho.org.uk/resource/item.aspx?RID=9714
or jump straight there http://www.yhpho.org.uk/atlas/dcosts/singlemap/atlas.html

General diabetes stats info, for the UK
Diabetes Community Health Profiles
http://www.yhpho.org.uk/diabetesprofiles.aspx

"The Diabetes Community Health Profiles bring together a wide range of data on
diabetes in adults into a single source for the purposes of benchmarking. The
tool allows you to download a diabetes profile for each PCT in England.

In order to locate the PCT profile you require please select a Strategic
Health Authority from the dropdown list. The tool will then generate a list of
PCTs within that Strategic Health Authority."

YHPHO*: Diabetes A-Z (rather useful)
http://www.yhpho.org.uk/default.aspx?RID=8468
*(Yorkshire & Public Health Observatory - I pronounce it yiffo myself...)

Diabetes Data Directory
Signposting to data sources relevant to diabetes.
http://yhpho.york.ac.uk/diabetesdd/introddd.asp

The printed word and http://

When I'm looking at a page of printed text I find it a bit hard to spot the web addresses embedded within it unless they are in colour or underlined. Web addresses written with www. at the beginning, instead of http://, just seem unfinished to me, and perhaps less easy to spot. An http:// or two is helpful to guide the eye, being the textual equivalent of a highlighter pen. A sensible alternative would be to put the web address at the end of the text and reference it in-text, and if it's a long address it's helpful to provide a shorter alternative to save whoever's typing it in from the printed page.

Some accessibility guidelines recommend against underlining text (presumably because the line interferes with the shape of the words but since we've managed to invent strikethrough and double strikethrough surely we can invent an underline that's lower down...) or italicising words, meaning that the links aren't made particularly salient. Sometimes links are presented in bold, which is a big help, but it depends on the house style.

This is when I skim read in hope of finding http:// as this 'word' looks different from all the other text on the page. It's probably the :// that's doing it but the h and the p form a nice shape too. Probably we've all got used to the idea that typing http:// into a browser address bar is generally redundant as the default setting is for web pages (although you have to be careful if you want to use the https:// format for secure pages).

In electronic documents internet addresses are usually more obvious. Pressing the space bar after typing one in my email programme (Outlook) or Word automatically turns the preceding address into a link or email address (of course you can set it so that it doesn't do this). In some email programmes the mailto: command isn't needed and the presence of an @ is enough to create a clickable email address, similarly the http:// isn't necessary and www.blah will resolve to an active link.

Plenty of web addresses don't even need the www, for example bit.ly and twitter.com. Having said that I notice that the http:// seems still to be required in tweets in order to render an address as a blue-text active link (similarly # in front of a word renders it as a link to the Twitter search results for that word).

Presumably someone can 'set' Twitter so that bit.ly/blah will go to http://bit.ly/blah in the way that someone must have done something to email a few years ago so that mailto: in front of an address would 'activate' it. But at least in these cases it's obvious what the link is, whatever it looks like.

But for printed pages, bring back the http://

With thanks to @the_beacon for the point about https and to @jjsanderson, @mokuska and @rpg7twit for disagreeing with me :)