Vaccine Conversations

30 01 2012

Parents have questions about the health and care of their children. It’s normal!

They want to know (for instance) what to give a child who has a high fever, when a multivitamin is appropriate, and if vaccines are safe and necessary.

It’s that last bit that has many of us searching for the words that parents want to hear. When a parent asks if vaccines are safe and necessary, it’s not enough to simply say yes. Parents want more information, and here are a few resources that will help you provide answers.

CDC has a section on their website that addresses the question of how to talk to parents and others about vaccines. There are materials for talking to specific groups, such as college-age students, healthcare workers, or pregnant women. There are materials to share with parents who are choosing not to vaccinate or who have questions about immunization schedules. There’s a one-pager for providers that’s handy to have. Basically, this site has gobs of resources—more than we have room for here—and is worth a long look.

The Colorado Foundation for Medical Care and Every Child by Two have a CE for nurses that offers “practical knowledge and skills on vaccine safety and patient communication.” It’s provided in webinar format and wraps up on 29 November, 2012. Try to get it on your calendars before then.

The Vaccine Education Center at CHOP has an excellent menu of articles written in palatable form for non-scientists. Few explain the facts behind vaccines better than Dr. Paul Offit, the Center’s director. This site is one of our favorites.

Immunization Action Coalition keeps a list of resources for those who speak with parents about vaccines. It’s a good page to bookmark.

We found a nice slideset by a nurse from GSK that provides answers to parents’ questions. It may be something you would want to share with your staff.

At PKIDs, we have several videos of parents sharing their children’s stories. Sometimes it helps to connect parent-to-parent. In addition to PKIDs, there’s ShotByShot, National Meningitis Association, and Families Fighting Flu—all of whom have videos to share.

While poking around, we found many more helpful sites, but when they were boiled down to their essences, the resources provided could be found in one of the sites listed above.

If you know of a site that has materials useful to the vaccine conversation, we’d love to hear from you in the comments.

By Trish Parnell

Image courtesy of Norman Rockwell Museum





PubMed: Obtaining Full-Text Journal Articles

23 04 2010

In our previous PubMed articles, we discussed finding free articles online and conducting more effective searches. In this PubMed post, we discuss ways to get full text articles that are not free online.

Visit Your Libraries

Local Library

Check with your local library to see if they have the journal in question, or if they can get it in for you. This may be your only recourse for getting full articles at no cost, even if you have to wait awhile to get the journal.

Nearest Medical Library

If your local library doesn’t have or cannot get the journal or article you want, contact your nearest medical library. Call the National Network of Libraries of Medicine at 800-338-7657 or visit their website to locate your nearest library. (You can’t call this number to get help finding information, but they can help you locate a library.)

Order Online Through PubMed

Loansome Doc

PubMed is primarily for medical students and professionals, which is why it provides a service called Loansome Doc that enables you to 1) find medical libraries in your state serving the general public, and 2) easily and conveniently order journal articles through PubMed.

When viewing an article’s abstract, clicking on the “Send To” link opens a box from which you can select “Order.” Clicking the “Order articles” button will direct you to enter your Loansome Doc login information.

PubMed Loansome Doc

Ordering option for Loansome Doc

Registration for Loansome Doc is free; you only pay when you order an article. To sign up for Loansome Doc, visit the Loansome Doc signup page.  The first step will help you locate a medical library near you. You will need to contact the medical library of your choice to get signed up with them.

If you are not a healthcare provider or student, the medical library will consider you an “unaffiliated user.” Each library will have different criteria regarding unaffiliated users, pricing, and document delivery formats (hardcopy vs. electronic, e.g.).

LinkOut

If you click on an article’s title in your PubMed search results, you can click “LinkOut” at the bottom of the abstract to see online sources providing full text. You do not need a Loansome Doc account for these, but you may have to set up an account on the website of the online source to place an order.

PubMed - LinkOut

Viewing options for ordering under LinkOut

So to sum up:

  • Try your local library or visit a medical library (if you have one close to you).
  • If you are planning to order articles on a relatively frequent basis, sign up for Loansome Doc so you can place all your orders from within PubMed.
  • If you are planning to order articles relatively infrequently, try ordering from a LinkOut service.
http://www.nlm.nih.gov/loansomedoc/loansome_home.html




Meningitis: A College Memory You Don’t Want

21 04 2010

A crowd of college students at the 2007 Pittsburgh University Commencement.Going away to school is a lifechanging experience. For many students, four years disappear into a haze of studying, working, and partying with their classmates. It’s a chaotic time where everything is shared: space, feelings, clothes, cars, and germs.

When a meningitis outbreak shows up in the news, it’s a good bet that it showed up at a school. Any shared spaces like schools, dorms, or barracks where crowds of young adults converge are favorite territories for bacteria and viruses to spread.

Meningitis, a serious but rare infection, is an inflammation of the membranes covering the brain and spinal cord. It affects about 1,500 Americans each year.

Meningitis is commonly mistaken for the flu in its early stages, and therefore left untreated. When this happens, it can do a lot of damage within hours, sometimes causing confusion, seizures, and brain damage. Survivors are often left with amputated limbs—permanent reminders of their experience.

So what does meningitis act like and why are colleges a prime environment for it?

Most meningitis patients complain of excruciating headaches, unyielding fevers, nausea, and vomiting. Sound like just a bad case of the flu? More telling are other symptoms, which include stiffness and pain in the neck (due to the swelling around the spinal cord and brain), sensitivity to light, numbness or loss of sensation in limbs, rashes, mental confusion, and convulsions and seizures.

Most at risk are college students. Busy, exhausted, and stressed students often have lowered immune systems. A wide variety of lifestyles and health choices create a melting pot of germs, especially when bathrooms and eating areas are shared. Meningitis is spread through contact with an infected person’s bodily fluid: a shared cigarette or drink, a kiss, a cough. It’s possible to carry a germ that causes meningitis and never be sick, while unknowingly passing it on to someone else. There are lots of ways to spread it.

Many such infections could be prevented with vaccination. Some schools are now requiring proof of vaccination; others only provide information about meningitis. Before heading off to college, make sure you’re protected and know what the warning signs are. Parents, if you’re reading this, make sure your son or daughter is protected before they leave you.  It could be the most important going-away gift you give your child.

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PubMed: Refining Searches with MeSH

5 04 2010

Our previous PubMed article described how you could search for journal articles using simple search terms, like you would on the Internet. However, if you want your search to be more targeted and effective, you should use MeSH search terms.

What’s MeSH? Sounds messy.

MeSH (Medical Subject Heading Terms) terms are medically-oriented keywords. Because PubMed is indexing medical journal articles, you will generate better search results if you use medical terms used by PubMed. Previously, our approach was:

  1. Enter keywords into PubMed
  2. Get results

Using MeSH terms, our approach will be:

  1. Enter keywords in MeSH to find MeSH terms
  2. Enter those MeSH terms into PubMed
  3. Get more targeted results

Great! How do I do this?

First, go to the MeSH homepage. Then enter a keyword in the search box, and click the “Go” button. In this example, we’ve entered “hepatitis” and the results are displayed below the term.

Finding MeSH terms

Click to enlarge

Every term or phrase listed here by number is a MeSH search term. Below each term is the definition for that term. Find the terms that most closely match what you have in mind, and check the box next to them. Then click the “Send to” drop-down box and choose “Search Box with AND.” A second search box appears above your search results with the MeSH term inside.

Sending MeSH terms to the new search box

Click to enlarge

Now you can add additional MeSH terms to further refine your search. Try entering “child” in the field at the top, and click “Go” to get MeSH terms related to “child.” Then click the box(es) next to your desired terms, and send them to the search box as you did in the step above.

If you want to exclude a term, choose “Search Box with NOT.”

If you want to search for articles that contain at least one of the terms you’ve sent to the search box, but not necessarily all of them, choose “Search Box with OR.”

Once you’ve sent your desired MeSH terms to the search box, click the “PubMed Search” button directly below it. You will then see a page of results, like the example below:

Getting results from your MeSH terms

Click to enlarge

You can now interact with the search results as we discussed in our previous PubMed article. Watch the blog for future articles on PubMed searching.





Searching Parents…Meet PubMed!

15 03 2010

When you’re a parent searching for information about your child’s medical condition, it doesn’t take long to exhaust the online resources most readily available. MedlinePlus…  Mayo Clinic…  WebMD…  But where do you go when you need more?

If you’re ready to dig deep, you can turn to journal articles for more information and research. One way to search journal articles is to visit NIH’s PubMed website.

You can enter keywords into the search box at the top of the page, and you will get results. But you’ll get a lot of them, and some won’t really be as targeted as you’d like. There are a number of ways to get better results, and we’ll be discussing these in upcoming posts, but today we’re going to show you the most economical: Filter by free text!

First, enter some keywords to search by and click the “Search” button. In our demo shots below, we use “chronic pediatric hepatitis.”

PubMed homepage

The next page will shows you some results. Depending on your personality, you’re either happy to see the 488 results returned by this search, or reeling with shock at the thought of sifting through 488 results! But for today’s purposes, we’re going to narrow our results the thrifty way, by clicking on “Free Full Text” on the right side of the screen.

Search results for "chronic pediatric hepatitis"

Below you can see the 61 free, full text articles available to you. Click on the “Free article” link under the citation.

Search results showing only those with free full text available

PubMed shows you services on the right that provide the article’s text free online. Choose one and start reading!

Links to free full text

Watch the blog for more posts on conducting targeted searches and finding full-text articles both on and offline.

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Kids and Sex, Gotta Have That Talk

15 02 2010

We have got to talk to our kids about sex (and related topics).  They’re going to snicker and act goofy or scowl and pretend to be annoyed, but they won’t run screaming from the room.  That’s because they want to know!

And we have to do it sooner rather than later.

On four separate occasions over the course of a year, 141 families of children aged 13-17 were surveyed concerning the timing of their chats about sexual topics.

Researchers found that over 50% of the teens had already experienced genital touching by the time their parents talked with them about birth control, sexually transmitted diseases and condom use.

More than 40% of the teens had already had intercourse by the time their parents talked with them about sexually transmitted diseases, condom use, choosing birth control and what to do if your partner refuses to wear a condom.

Why do we as parents allow this to happen?  Research suggests that we don’t have an accurate sense of where our children are in the stages of sexual exploration.

We all know that kids are exposed to sexual images and ideas through movies, music, magazines, and television at ever earlier ages.  This influences them in ways we parents may not be prepared to anticipate.

We want to protect our kids.  Most parents aren’t willing to bet their child’s health or life on an assumption that the child will abstain from sex until the parent thinks he or she is ready.

Experts suggest starting the conversation two years earlier than the age we think is appropriate. Don’t wait until just before we think the child is ready to explore sexual contact.

Sexuality is natural, it’s a part of being human, and it’s not just about sex.  Sexuality encompasses gender, interactions with the opposite sex, how men and women and boys and girls express emotion, body image, intimacy, and sexual orientation.

The kids may not listen when we tell them to take out the trash, but 63% of teens say being able to talk to their parents about sex makes it much easier to postpone sexual activity and avoid teen pregnancy.

Wooohooooo!  Parents doin’ the happy dance!

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