Cochrane Library: Free access for all?

cclogo.gif  In an ideal world, all health information would be available to all people. The databases contained in the Cochrane Library are an invaluable resource for health professionals, particularly the Cochrane Database of Systematic Reviews, and there is a global movement to make the Cochrane Library available to all.

A number of countries now offer their citizens free access to the Cochrane Library because they have obtained national provisions. Currently there are two online petitions to receive national provisions, one in Canada and one in Europe.

In Canada, people residing in New Brunswick, Northwest Territories, Nunavut, Yukon, Nova Scotia and Saskatchewan have free access to Cochrane. Other Canadians who wish to have this access are encouraged to sign this petition, entitled A National License to The Cochrane Library for Canada. The petition is administered by the Canadian Health Libraries Association / Association des bibliothèques de la santé du Canada.

In Europe the petition is entitled Petition to the European Commission to finance EU Provision to the Cochrane Library.

In the United States, Wyoming is the only state with free access. I haven’t been able to find an online Cochrane petition for the United States. (Create your own online petition here.)

Here is a sampling of countries that offer free access to the Cochrane Library:
Australia; Denmark; England; Finland; Island of Ireland (Health Research Board in Dublin and The Research and Development Office in Belfast); Scotland; South Africa; New Zealand; Norway (Norwegian Health Services Research Centre); Sweden; Wales (Welsh Assembly Government).

There are also several programmes that provide free access in Latin America and low-income countries.  For more information see this link.

Click on this image to see a list of countries with free access:     cochrane_free.png

Self-Assessment: JCEHP theme issue

jcehp_new.gif  The Winter 2008 issue of the Journal of Continuing Education in the Health Professions contains a number of excellent articles on self-assessment [available by subscription only]. Click on the links below to view the PubMed records for each article.

Joan Sargeant. Toward a common understanding of self-assessment (p 1-4)

Ronald M. Epstein, Daniel J. Siegel, Jordan Silberman. Self-monitoring in clinical practice: A challenge for medical educators (p 5-13)

Kevin W. Eva, Glenn Regehr. I’ll never play professional football and other fallacies of self-assessment (p 14-19)

Robert M. Galbraith, Richard E. Hawkins, Eric S. Holmboe. Making self-assessment more effective (p 20-24)

Ivan Silver, Craig Campbell, Bernard Marlow, Joan Sargeant. Self-assessment and continuing professional development: The Canadian perspective (p 25-31)

Tim Dornan. Self-assessment in CPD: Lessons from the UK undergraduate and postgraduate education domains (p 32-37)

Research Articles
F. Daniel Duffy, Lorna A. Lynn, Halyna Didura, Brian Hess, Kelly Caverzagie, Louis Grosso, Rebecca A. Lipner, Eric S. Holmboe. Self-assessment of practice performance: Development of the ABIM Practice Improvement Module (PIMSM) (p 38-46)

Joan Sargeant, Karen Mann, Cees van der Vleuten, Job Metsemakers. Directed self-assessment: Practice and feedback within a social context (p 47-54)

Lisa Moore, Richard Handfield-Jones. Mini-medical school: A legitimate role for university CME offices (p 55)

Jean Gray. The teacher’s teacher (p 56)

Book Reviews
Barbara J. Daley. Update of a classic on adult learning (p 57)
Bruce J. Bellande. It’s how, not what, doctors think (p 58)

Individual patient education for low back pain (Cochrane Review)

cclogo.gif  A January 2008 version of this Cochrane Review, first published last September, is now available online [subscription required to view the complete review]:

Engers A, Jellema P, Wensing M, van der Windt DAWM, Grol R, van Tulder MW. Individual patient education for low back pain. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004057.   PubMed Record

Plain Language Summary:
Low-back pain is a very common condition, particularly in developed countries. It can cause a great deal of pain and lost activity.

Health professionals use patient education to help people learn about low-back pain and what to do about it, including:
– Staying active and returning to normal activities as soon as possible
– Avoiding worry
– Coping with having a sore back
– Ways to avoid strain and avoid future back injuries.

Patient education can mean a discussion with a health professional, a special class, written information such as a booklet to take home, or other formats such as a video.

This review found 24 trials testing different types of patient education for people with low-back pain. The outcomes measured included pain, function and return-to-work.

People with low-back pain who received an in-person patient education session lasting at least two hours in addition to their usual care had better outcomes than people who only received usual care. Shorter education sessions, or providing written information by itself without an in-person education session, did not seem to be effective.

People with chronic (long-term) low-back pain were less likely to benefit from patient education than people with acute (short-term) pain.

Patient education was no more effective than other interventions such as cognitive behavioural group therapy, work-site visits, x-rays, acupuncture, chiropractic, physiotherapy, massage, manual therapy, heat-wrap therapy, interferential therapy, spinal stabilisation, yoga, or Swedish back school. One study found that patient education was more effective than exercises alone for some measures of function.

Studies that compared different types of patient education did not find clear results on which type was most effective. Some studies found that written information was just as effective as in-person education.

There appeared to be no harmful effects of patient education. Although there were 24 studies included in the review, most treatments were only tested by one or two studies. More research is needed to confirm these results, and to find out which types of patient education are the most effective.

Authors’ conclusions:
For patients with acute or subacute LBP, intensive patient education seems to be effective. For patients with chronic LBP, the effectiveness of individual education is still unclear.

See also Low Back Pain: Spine articles about Cochrane Reviews 

Top 10 Amazing Chemistry Videos

Here are some really funny and amazing chemistry videos, from Wired Science magazine. As they state, Fiery explosions, beautiful reactions, and hilarious music videos are great reasons to be excited about chemistry. My favourite is the one pictured above, a commercial that’s a music video about polymerase chain reaction (PCR) that parodies those celebrity music videos. The burning Gummy Bear is pretty good, too.

The Top 10

10. Thermite vs. Liquid Nitrogen
9. Gummy Bear Dies a Fiery Death in Potassium Chlorate
8. German Scientist Spits Flaming Spores
7. The PCR Song (commercial for a BioRad thermocycler, which is essentially a DNA copying machine
6. Mysterious Reaction Creates an Undulating Brew
5. How to Make Stalagmites Instantly
4. Elephant Toothpaste
3. How to Make Your Own Glow Sticks
2. The Inner Life of A Cell (beautiful animation)
1. Magnesium Burning Between Bricks of Dry Ice

The reported validity and reliability of methods for evaluating continuing medical education: A systematic review

acadmed.jpg  This review appears in the March 2008 issue of Academic Medicine [subscription required]:

Ratanawongsa N, Thomas PA, Marinopoulos SS, Dorman T, Wilson LM, Ashar BH, Magaziner JL, Miller RG, Prokopowicz GP, Qayyum R, Bass EB. The reported validity and reliability of methods for evaluating continuing medical education: A systematic reviewAcad Med 2008; 83(3):274-283.

PURPOSE: To appraise the reported validity and reliability of evaluation methods used in high-quality trials of continuing medical education (CME).
METHOD: The authors conducted a systematic review (1981 to February 2006) by hand-searching key journals and searching electronic databases. Eligible articles studied CME effectiveness using randomized controlled trials or historic/concurrent comparison designs, were conducted in the United States or Canada, were written in English, and involved at least 15 physicians. Sequential double review was conducted for data abstraction, using a traditional approach to validity and reliability.
CONCLUSIONS: The evidence for CME effectiveness is limited by weaknesses in the reported validity and reliability of evaluation methods. Educators should devote more attention to the development and reporting of high-quality CME evaluation methods and to emerging guidelines for establishing the validity of CME evaluation methods.
Read the full abstract    PubMed Related Articles

A snowy March morning …

I’m looking out my window on a snowy March morning The view from my window early on March 8 and a hungry little red squirrel braves the snow …Brave little red squirrel  
These seeds are soooo goodFood is more important than snow   But who is that on the other side of that window? Who is that watching me?  Uh, oh, I don’t like the look of her at allMust you point that thing at me? Better get away from her and score some more foodJust hanging out in the snow  MT-V in squirrel country   MT-V in squirrel country 
Trying to save the magnolia tree MT-V saves the magnolia tree — Choose a book to match your needs

mood.png  Do you ever go to a library or bookstore and not have a clue about what book to look for? Well, here is help, from, and it’s really fun to use. On one screen you can choose the mood and length and other qualities (click on the above screen shot for an example), and you can even move the levers to choose the degree of your choices.

On the other screen you can choose elements of character, plot and setting:
plot.png  Here I chose female, quest, Canada, and the database produced Margaret Atwood’s Alias Grace, one of my favourite books!  Some facts about

The books in the database are all fiction and poetry in paperback written in or translated into English and published since 1995.

Instead of starting from the overwhelming choice of books available, whichbook starts from the reader and enables each individual to build the elements of that elusive ‘good read’ we are all looking for but don’t quite know how to define.

The standard way of organising books for choice, on shelves in a library or a bookshop, or on the web, starts from the products available – the authors, titles, publishers or genres. Whichbook enables, for the first time, the choice of book to start from the individual reader and what they are looking for.

The producers:
Whichbook is managed by Opening the Book Ltd, who founded the reader development movement in the UK and create reader-centred approaches to promoting literature.