Medical jargon

Interesting brief opinion piece in today's Guardian - This epidemic of medical jargon isn't good for us - Professor Jonathan Wolff discusses the linguistic reasons for a professional jargon and advocates:

To take better care of our health, we need access to clear information. I concede that some specialised technical vocabulary is needed and useful. But many terms seem to be used purely to give medical professionals a spurious sense of precision and authority, while policing the boundaries of the subject; keeping out the riff-raff. If the Chinese, to improve literacy, can simplify their written script, can we not simplify medical terminology to improve health literacy?

Autism and Second Life

Great brief piece on CNN's site today about a place in Second Life, Naughty Auties, developed by a young man with Asperger's Syndrome, meant to give those with autism a place to meet online and to provide more information about the autism spectrum disorders.

CNN is going to focus on autism spectrum disorders all day on Wednesday April 2.

Another surgery game

I spent way too much time playing this last night -- Amateur Surgeon, a game from [adult swim].

You play a pizza boy with an interest in surgery who operates on a variety of interesting characters, using a pool table in an old warehouse as his OR and a mismash of tools (stapler, lighter, pizza cutter), under the supervision of a disgraced surgeon.

I had to give up last night after I killed poor Claude 4 times...

Andrew Jackson's "myriad of diseases"

In honor of President's Day, Jake Young of the Pure Pedantry blog has a great post about the complex and interesting medical history of Andrew Jackson -- Presidential Medicine: Andrew Jackson.

JMLA article

Brief moment of shameless self promotion :-) - a paper based on my MPH thesis in included in this month's JMLA -

Jerome RN, Giuse BN, Rosenbloom ST, Arbogast PG. Exploring clinician adoption of a novel evidence request feature in an electronic medical record system. J Med Libr Assoc. 2008 January; 96(1): 34–41. The abstract:

Objective: The research evaluated strategies for facilitating physician adoption of an evidence-based medicine literature request feature recently integrated into an existing electronic medical record (EMR) system.

Methods: This prospective study explored use of the service by 137 primary care physicians by using service usage statistics and focus group and survey components. The frequency of physicians' requests for literature via the EMR during a 10-month period was examined to explore the impact of several enhanced communication strategies launched mid-way through the observation period. A focus group and a 25-item survey explored physicians' experiences with the service.

Results: There was no detectable difference in the proportion of physicians utilizing the service after implementation of the customized communication strategies (11% in each time period, P=1.0, McNemar's test). Forty-eight physicians (35%) responded to the survey. Respondents who had used the service (n=19) indicated that information provided through the service was highly relevant to clinical practice (mean rating 4.6, scale 1 “not relevant”–5 “highly relevant”), and most (n=15) reported sharing the information with colleagues.

Conclusion: The enhanced communication strategies, though well received, did not significantly affect use of the service. However, physicians noted the relevance and utility of librarian-summarized evidence from the literature, highlighting the potential benefits of providing expert librarian services in clinical workflow.

A common health language

The newsletter ADVANCE for Health Information Management Professionals has a really nice brief article on health literacy, "Dream of a Common Health Language" by Shawn Proctor. The article a few simple but striking examples from the world of respiratory therapy to illustrate signs and potential implications of low health literacy.

For Mari Jones, RRT, FNP, AE-C, the predicament hit home when she found her college-educated father struggling to understand his doctor's instructions. He had returned home knowing he should stop taking one of three medications. But he was unclear as to which one. He didn't want to admit he didn't understand.

The article mentions The Newest Vital Sign, a health literacy test that Pfizer makes freely available and the NN/LM health literacy page.

Epigenomics initiative

Today, the NIH announced a new initiative focused on developing the field of epigenomics in the US.

What is epigenomics, you ask?

The press release defines the field:

Epigenetics focuses on processes that regulate how and when certain genes are turned on and turned off, while epigenomics pertains to analysis of epigenetic changes across many genes in a cell or entire organism.

Epigenetic processes control normal growth and development. Diet and exposure to environmental chemicals throughout all stages of human development among other factors can cause epigenetic changes that may turn on or turn off certain genes. Changes in genes that would normally protect against a disease, as a result, could make people more susceptible to developing that disease later in life. Researchers also believe some epigenetic changes can be passed on from generation to generation.

And an example might help:

...epigenetics may help explain how some people are predisposed to certain illnesses such as cardiovascular disease, diabetes and hypertension. Several studies have documented that children born to mothers who did not get adequate nutrition during pregnancy were more likely to develop type 2 diabetes and coronary heart disease later in life. The theory is that epigenetic changes occur in genes that regulate sugar absorption and metabolism during fetal development that allow for survival with little food, but when encountered with an environment where food was plentiful these changes led to development of diabetes. (See scientific illustration of how epigenetic mechanisms can affect health at http://nihroadmap.nih.gov/epigenomics/epigeneticmechanisms.asp .)

More on epigenomics and epigenetics:
- NIH Roadmap: Epigenomics
- Biology Online: Introduction - from genome to epigenome - this intro notes "
The term ‘epigenetics’ was first introduced by Conrad Waddington in the 1940s to describe ‘the interactions of genes with their environment, which bring the phenotype into being’"
- the Human Epigenome Project