Few fields develop as rapidly as medicine, with new breakthroughs in research, tools, and techniques happening everyday. This presents an interesting challenge for many medical publishers — trying to get the latest information to students, practitioners, and researchers as quickly and accurately as possible. So we are delighted to present a Q&A with Associate Editorial Director of Medicine Books, Craig Panner. Craig began his career at Oxford University Press eight years ago, and currently works across Oxford University Press’s medicine titles. In the interview below, Craig talks not only about his role, but also the medical publishing landscape in general, both past and future.
Could you tell us about your position as Associate Editorial Director?
My role is something of an interdepartmental liaison between the Medicine UK office and the psychology and social work group here at Oxford University Press. Collectively, we all work very closely together and when you have departments on both sides of the Atlantic, I think it is imperative to maintain and promote open lines of communication which is what I strive to do on a daily basis. Additionally, as Associate Editorial Director, I am also the commissioning editor for neurology and neuroscience, a role which I not only love, but I think helps keep me connected to, and informed about, what the other commissioning editors encounter on a daily basis.
In your experience, what are some of the challenges of transitioning medical books to an online environment?
I think one of the biggest challenges is that everyone has ideas of what they want, what functionality they expect, and how to be able to use that material. But like many things, we can’t please everyone so it becomes a matter of identifying the greatest common need and how to meet those requirements. Another large challenge is that the online environment is a constantly moving target, if you will: new functionalities are introduced, the “it” product is rolled out, and other similar bells and whistles are discovered and customers often want that too. But when we’re talking about a platform product like Oxford Medicine Online and the huge amount of data that is available, it’s often too difficult to demonstrate why instant changes can’t be incorporated.
What was the state of medical publishing when you began your career vs. how it is done now?
When I started in the publishing world (as a proofreader) back in 1992, everything was print. I remember when the company received its first apple computer: it was kept in an open office and you had to sign up to book time to use it. And, oddly, it was never in use: everyone was more comfortable using the mimeograph machine and the typewriters by their desk. But, in about the next five or six years, the online explosion happened and journals suddenly became available electronically, first via consortia only, then as individual subscriptions, and then individual articles.
Could you discuss Oxford’s relationship with the Mayo Clinic, and how it has grown or changed over the years?
Mayo Clinic is the largest integrated, not-for-profit group practice in the world, with nearly 4000 physicians and scientists at their three primary sites in Minnesota, Florida, and Arizona. And given that Oxford University Press is the largest and oldest university press in the world, it seemed like a natural fit for the two organizations to work together. For almost five years now, Mayo Clinic and Oxford University Press have continued to work together to create, prepare, and disseminate medical reference works that any practicing clinician, anywhere in the world, would find useful for their continued professional development. When we first began working together, the Mayo Clinic Scientific Press series of books was predominantly print. But with the launch of Oxford Medicine Online, and the subsequent development of the Oxford eLearning Platform, the Mayo titles now have the added functionality of utilizing the questions and answers that accompany many of the Mayo Clinic Board Review books for a truly interactive experience that more fully prepares doctors preparing to take their board exam, as well as doctors maintaining their certification, in a real time environment.
What are some of the greatest challenges of medical publishing?
Everyone is busy and everyone works more than a 40-hour week. Finding the time to develop and undertake, much less publish, a medical text is a real juggling act. Thankfully, with the history of Oxford University Press and the quality publications that we produce, we are a trusted publishing house where authors and editors can go with confidence. Another challenge in medical publishing is the time that it takes to produce a work. Not only does it take a fair amount of time to develop, to write or collate chapters, and to deliver the work, but in the old days, it would take a year to publish a book. Medical research and techniques move far more quickly than that time-frame would permit which is why the Medicine group now publishes works between 3.5 months to 5.5 months from receipt. All to better meet the needs of our readers.
Where do you think medical publishing is headed in the future?
I wish I knew! The electronic environment will obviously play a huge role for the rest of my career but given that it, literally, changes daily and the needs and expectations of our readers changes with it, it is impossible to guess where things are going. And that’s what makes publishing so much fun. I can say that I think that immediate access to point of care information, along with suggested secondary and tertiary information will become second nature. The online environment won’t do the thinking for the clinician, but it will certainly supplement their decision making and knowledge base far more completely than anything that we’ve had previously.
How has the process of actually doing medical research changed over the years? In other words, how are people accessing the content then vs. now?
Medical research has definitely changed over the years. When I first started out, clinicians and researchers had offices lined with books and journals, filing cabinets filled with journal reprints, and personal databases (for the electronically savvy) of key articles. Much of that is gone now and when you speak with a junior doc they will often say that everything they need is available to them electronically. Searching the web is obviously faster but the ability to utilize the web to link journals, books, databases, and the like has expanded the available knowledge base of today’s clinician, no matter where in the world they are located. And because of how we do research and how we follow up with patients, a doctor can now check up on, and advise upon, a patient from anywhere that they are traveling to. Geographic boundaries really no longer exist.
How have extra online features, like multimedia, changed the way medical research is done?
The various additional features that the online environment facilitates are amazingly useful in this busy world we live in. Not only do these extra features teach the reader on their own schedule, but these features can help facilitate the decision making process. If we are talking about videos that show two different, but somewhat similar, symptoms the multimedia material can help show, literally, how the two disorders are different. Likewise, being able to quickly reference additional material via a third party database–let’s say genotypes, for instance–you negate the need to stop what you’re doing, go to a book, a journal, or even the library but, instead, go directly to the source, find what you need, make the judgment and continue with your work. Medical research really is nothing like it was five years ago and will not be the same five years from now.
Craig Panner is the Associate Editorial Director of Medicine Books, and works in Oxford’s New York office.
Oxford Medicine Online is an interconnected collection of over 500 online medical resources which cover every stage in a medical career. Our aim is to ensure that the site delivers the highest quality Oxford content whilst meeting the requirements of the busy student, doctor, or health professional working in a digital world.
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The Mayo Clinic Scientific Press suite of publications is now available on Oxford Medicine Online. To highlight some of the great resources, we’ve pulled together some interesting facts about the esphophagus from Stephen Hauser’s Mayo Clinic Gastroenterology and Hepatology Board Review.
(1) The esophagus has two major functions: to propel food boluses downward to the stomach and to keep stomach contents from refluxing upward. The esophagus accomplishes these functions by its tubular anatomy and motility that involves the contraction and relaxation of sphincter muscles and precisely timed peristaltic waves.
(2) The initial process of swallowing is under voluntary control. A swallow is initiated by the lips closing, the teeth clenching, and the tongue being elevated against the palate, forcing the bolus to the pharynx. Entry of the bolus into the pharynx triggers the involuntary swallowing reflex.
(3) Oropharyngeal dysphagia is often characterized by the complaint of difficulty initiating a swallow, transitioning the food bolus or liquid into the esophagus, meal-induced coughing or “choking,” or of food “getting stuck” in the voluntary phase of swallowing.
(4) Patients with an esophageal body or LES disorder describe “esophageal dysphagia” characterized by the onset of symptoms moments after the initiation of a swallow. They usually can sense that the food or liquid bolus has traversed the oral cavity and has entered the esophagus. They complain of food feeling “stuck” or “hung up” in transition to the stomach.
(5) Gastroesophageal reflux is the reflux of gastric contents other than air into or through the esophagus. Gastroesophageal reflux disease (GERD) refers to reflux that produces frequent symptoms or results in damage to the esophageal mucosa or contiguous organs of the upper aerodigestive system and occasionally the lower respiratory tract.
Gastroenterology and hepatology encompass a vast anatomical assortment of organs that have diverse structure and function and potentially are afflicted by a multiplicity of disease processes. Mayo Clinic Gastroenterology and Hepatology Board Review is designed to assist both physicians in-training who are preparing for the gastroenterology board examination and the increasing number of gastroenterologists awaiting recertification.
The Mayo Clinic Scientific Press suite of publications is now available on Oxford Medicine Online. With full-text titles from Mayo Clinic clinicians and a bank of 3,000 multiple-choice questions, Mayo Clinic Toolkit provides a single location for residents, fellows, and practicing clinicians to undertake the self-testing necessary to prepare for, and pass, the Boards and remain up-to-date. Oxford Medicine Online is an interconnected collection of over 250 online medical resources which cover every stage in a medical career, for medical students and junior doctors, to resources for senior doctors and consultants. Oxford Medicine Online has relaunched with a brand new look and feel and enhanced functionality. Our aim is to ensure that the site continues to deliver the highest quality Oxford content whilst meeting the requirements of the busy student, doctor, or health professional working in a digital world.
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How can you resolve to change in 2013? With a community. The Mayo Clinic Scientific Press suite of publications is now available on Oxford Medicine Online, and to highlight some of the great resources, we’ve excerpted Prathibha Varkey, MD, MPH, MHPE’s Mayo Clinic Preventive Medicine and Public Health Board Review below.
Community and population health can be enhanced by recognizing the different levels of influence, namely intrapersonal, interpersonal, and organizational influences. More recently, attention is being paid to the importance of interpersonal influences through the study of social networks. Smoking cessation rates of individuals increase as more contacts in their social network quit smoking, and individuals gain weight as more contacts in their social network gain weight. Another example of social influence is an after-school program for teenagers that may not change attitudes but may reduce the opportunity to engage in risky behaviors. Organizational support for behavior change can be in the form of higher taxes on tobacco or alcohol, building recreational centers to enhance physical activity, cleaning up the environment (in one study, neighborhood deterioration was a better predictor of sexually transmitted disease than low education attainment), and using or regulating message delivery by the media.
Bringing about change at the population level may follow the principles of diffusion of innovation, as described by Everett Rogers. In this model, the social system comprises five adopter categories: (1) innovators, (2) early adopters, (3) early majority, (4) late majority, and (5) laggards. Innovators are important for change because they get the process started, but they are not very influential because too much uncertainty about the changed behavior still exists when they adopt the change. The early adopters are key to diffusing an innovation; this group tends to include the opinion leaders, and others usually solicit their advice about new innovations. This model of diffusion of innovation predicts whether innovations and change will be successful on a large scale.
How rapidly an innovation will be diffused depends on the characteristics of the innovation, how it is communicated, and the social system. The characteristics of innovation that determine its speed of adoption include its perceived relative advantage over current practice, compatibility with current practices and needs of the adopters, ease of use (simple vs complex), “trialability” (testable on a small scale), and observability (visibility of results).
The principles of this model can be useful for predicting behavior change or diffusion of best practices at the community or population level. For example, screening mammography has been widely adopted by physicians because it is perceived to detect early stage breast cancer, the test is easy for physicians to order, patient compliance is not burdensome, and results are visible in a short time. In contrast, smoking cessation counseling has been slower to diffuse because the results are not as visible (most people will not quit when advised to do so), the intervention is more complex than just ordering a test, and physician practices are not geared toward counseling.
- Intrapersonal, interpersonal, and organizational influences affect community and population health.
- Health changes at the population level may propagate in a manner predicted by the principles of diffusion of innovation.
A comprehensive and concise review of relevant preventive medicine and public health topics, the Mayo Clinic Preventive Medicine and Public Health Board Review is an ideal study guide for residents preparing to take the examination of the American Board of Preventive Medicine for the first time, as well as for physicians preparing for recertification. Its emphasis on evidence-based information and recommendations makes Mayo Clinic Preventive Medicine and Public Health Board Review a credible, practical resource that can be used in clinical, public health, and academic settings
The Mayo Clinic Scientific Press suite of publications is now available on Oxford Medicine Online. With full-text titles from Mayo Clinic clinicians and a bank of 3,000 multiple-choice questions, Mayo Clinic Toolkit provides a single location for residents, fellows, and practicing clinicians to undertake the self-testing necessary to prepare for, and pass, the Boards and remain up-to-date. Oxford Medicine Online is an interconnected collection of over 250 online medical resources which cover every stage in a medical career, for medical students and junior doctors, to resources for senior doctors and consultants. Oxford Medicine Online has relaunched with a brand new look and feel and enhanced functionality. Our aim is to ensure that the site continues to deliver the highest quality Oxford content whilst meeting the requirements of the busy student, doctor, or health professional working in a digital world.
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The Mayo Clinic Scientific Press suite of publications is now available on Oxford Medicine Online. To highlight some of the great resources, we’ve pulled together some interesting facts about anesthesia from James Hebl and Robert Lennon’s Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade. Get free access to the Mayo Clinic suite for a limited time with this Facebook offer (watch out, it closes today!).
(1) Egyptian pictographs dating back to 3000 BC showing a physician compressing a nerve in the antecubital fossa while an operation is being performed on the hand.
(2) William Halsted, M.D. (1852–1922; Chair, Department of Surgery, Johns Hopkins Hospital), used cocaine as local infiltration as he dissected down toward major nerve trunks. He then injected cocaine around them, performing regional blockade under direct vision.
(3) In Paris in the early 1920s, a new technique for blocking the brachial plexus from an axillary approach was introduced. M. Reding, M.D., studying the anatomy of the axilla, discovered that the nerves of the plexus surround the artery in a fascial sheath. Thus, using the artery as a landmark, Reding found that the fascial compartment could be filled with local anesthetic to result in brachial plexus blockade. Reding blocked the musculocutaneous nerve, which lay outside the sheath, by infiltrating the coracobrachialis muscle.
(4) Paresthesia technique—the long-preferred method of regional anesthesiologists—was slowly replaced during the 1980s as peripheral nerve stimulation began to emerge. During its development, peripheral nerve stimulation was thought to provide superior localization of neural structures compared with blind paresthesia-seeking techniques. Peripheral nerve stimulators transmit a small electric current through a stimulating needle that, when in proximity to neural structures, causes depolarization and muscle contraction.
(5) In contemporary medical practice, regional anesthetic techniques have expanding socioeconomic and clinical implications. For example, studies evaluating patient satisfaction have found that perioperative analgesia and the avoidance of nausea and vomiting are consistently two of the highest concerns among patients.
(6) Ultrasound guidance may represent the 21st century’s version of Halsted’s anatomical dissection down to the brachial plexus.
Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade by James Hebl and Robert Lennon is a practical guide for residents-in-training and clinicians to gain greater familiarity with regional anesthesia and acute pain management to the upper and lower extremity. It emphasizes the importance of a detailed knowledge of applied anatomy to safely and successfully performing regional anesthesia. It also provides and overview of the emerging field of ultrasound-guided regional anesthesia, which allows reliable identification of both normal and variant anatomy. Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade contains more than 200 beautifully illustrated anatomic images important to understanding and performing regional anesthesia. Corresponding ultrasound images are provided when applicable.
The Mayo Clinic Scientific Press suite of publications is now available on Oxford Medicine Online. With full-text titles from Mayo Clinic clinicians and a bank of 3,000 multiple-choice questions, Mayo Clinic Toolkit provides a single location for residents, fellows, and practicing clinicians to undertake the self-testing necessary to prepare for, and pass, the Boards and remain up-to-date. Oxford Medicine Online is an interconnected collection of over 250 online medical resources which cover every stage in a medical career, for medical students and junior doctors, to resources for senior doctors and consultants. Oxford Medicine Online has relaunched with a brand new look and feel and enhanced functionality. Our aim is to ensure that the site continues to deliver the highest quality Oxford content whilst meeting the requirements of the busy student, doctor, or health professional working in a digital world.
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The post Six facts about regional anesthesia appeared first on OUPblog.
Off to Rochester, Minnesota!
Again, I'm asking for your good luck wishes, prayers, thoughts, etc., for Kate as we try to find a way to get her feeling well again.
I hope our Mayo Clinic experience is as good as it was last time.
Also, I hope to see some TC members at my signing on Sunday. :)
xoxo
This tiny charming town in NW Florida, with a population of just over 1,200, is the Seat of Lafayette County government.
Lafayette County Courthouse
The old Lafayette County Courthouse, built in the 1890′s, is now a Bed and Breakfast
Thank you so much, Jayllex M. for sending your contest entry! Your bay is gorgeous and I, you know, might be a little in love with your pink and white lead rope. :)
Keep the pics coming guys! It's making me feel so much closer to you all--to put a face to the readers I get e-mails from. It's really the coolest thing.
Kate has a big test today at Mayo. Yesterday was not a great day, but we're trying to shake it off and start fresh today. #TeamKate's running on nerves and adrenaline, I think. Or at least, I am.
We got a DVD player for the hotel room, which has been awesome. We restarted GLEE season 1 on Blueray which has tons of extra footage. We also brought 2 seasons of MAKE IT OR BREAK IT, STICK IT, BURLESQUE and a bunch of other chick flicks. :)
Kate sends her love to all of you and thanks you from the bottom of her heart for the Facebook notes and blog comments. I show her every single one. You all make her feel sparkly and special.
I've been using my time in the waiting room to respond to emails from Team Canterwood. I need the distraction and writing you all has been so nice. I've sent about 25 emails and have about 1005 left to go. :) I've read them all, I just haven't been able to respond because of my writing schedule.
What are you guys up to? Are you out of school yet or just about finished? What are you most looking forward to doing this summer?
<3
xoxo
PS: Have you watched THE VOICE? At first, I was like, "No way." Then I watched an episode and it's a fantastic show! I'm glad Christina Aguilera is back on her feet. She's crazy talented.
Man i wish i was there. Can you come to Cary, North Carolina sometime. Because i would really love to meet you.
Sooooooooo excited cu there!!!!:)
Update Lauren's blog pleass!!!!
Have a great trip. Best of everything!
Madelyn: lol, we should all three meet up in norfolk or oxford.... i live in VA beach! :)
anywho, loving kemps landing soo far.... :) my english teacher is my fave, (duh!) and i love that i have art every day! :)
AND i actually asked my mom if she would drive me to rochester (a CRAZY-long drive, and my dads out of town) and she saiiddd........................
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmNO!mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
D: oh well... i guess i didnt expect a yes....
have fun, good wishes, good luck, and, as always, you and Kate are in my prayers. :) <3 Sam
**the mm's had a NO in the center!
I hope Kate is doing very well, good luck to you both. Wish I could be at your signing, Jess. My horse Goldie, he died yesterday. :(
neato i wish i lived around there........good luck jess u should really come to Chi-town some time :)