The document discusses a clicker test asking whether patients should be able to view doctors' notes. The three response options are: definitely yes, absolutely no, and maybe it depends.
It then cites a 2012 study from the Annals of Internal Medicine that was a quasi-experimental study inviting patients to read their doctors' notes. The study provides a link to the PubMed entry for the study.
Finally, it lists "Finding Medical Information" and "Basis of Medicine, Unit 2, October 2012" suggesting this is part of a lecture presentation on finding medical information.
Annotation examples. This is an overview of some of the software I have used for annotation (and a few extra features some of this software has.) This was presented in the SwissUniversities Doctoral Programme, Language & Cognition, in the Module: Linguistic and corpus perspectives on argumentative discourse.
Screenshots are given of GATE, UAM Corpus Tool, Excel, BRAT, EPPI Reviewer, and a custom tool. In most cases there are references to one of my papers for further details.
I briefly describe a typical annotation process:
Find text of interest
Find phenomena of interest
Draft an annotation manual
Iteratively test annotation & revise manual
Find questionable annotations, check disagreements.
Revise the manual.
Iterate.
Annotate
Describe the major available electronic resources
Describe how to build a search strategy
Describe some alternate sources for finding trials
Describe what to do once you get your search results
Clinical Research for Medical StudentsAhmed Negida
This presentation discusses (1) the importance of clinical research to medical students, (2) barriers towards student research, and (3) how to select a good mentor.
Annotation examples. This is an overview of some of the software I have used for annotation (and a few extra features some of this software has.) This was presented in the SwissUniversities Doctoral Programme, Language & Cognition, in the Module: Linguistic and corpus perspectives on argumentative discourse.
Screenshots are given of GATE, UAM Corpus Tool, Excel, BRAT, EPPI Reviewer, and a custom tool. In most cases there are references to one of my papers for further details.
I briefly describe a typical annotation process:
Find text of interest
Find phenomena of interest
Draft an annotation manual
Iteratively test annotation & revise manual
Find questionable annotations, check disagreements.
Revise the manual.
Iterate.
Annotate
Describe the major available electronic resources
Describe how to build a search strategy
Describe some alternate sources for finding trials
Describe what to do once you get your search results
Clinical Research for Medical StudentsAhmed Negida
This presentation discusses (1) the importance of clinical research to medical students, (2) barriers towards student research, and (3) how to select a good mentor.
Lecture given to Unit 8 (INDS 208) -- Pathobiology Treatment and Prevention of Disease -- in the undergraduate medical curriculum at McGill University on September 10, 2012.
RESEARCHQUIET TIME IN NEURO ICU 5Running Head RESEARCH ICU QU.docxdebishakespeare
RESEARCH:QUIET TIME IN NEURO ICU 5
Running Head: RESEARCH: ICU QUIET TIME 1
Researchable Topic: ICU Quiet time
Ese Nosakhare
Nurs-6052N Essentials of Evidence-Based Practice
June 13, 2015
Researchable Topic: ICU Quiet time DS Dr. Sullivan Title needed when you begin on page two. This title should be the same as the title page, centered and not bolded
The identification of research problem is the first and foremost step that every researcher has to undertake. What is hard for a nurse to do in evidence-based practice (EBP) is coming up with a clinical question that can be answered with research evidence (Polit & Beck, 2012). Knowing this, a clinical question that is patient focuseds and important significant to nursing can help obtain the knowledge needed to addressing the needs of certain patient populations (Thibane, Thomas & and Ye, 2009). A nurse making a clinical question that can be answered requires a game plan that can identify pertinent nursing issues. Furthermore, the nurse must put that nursing issue into an easy format to research. Doing so will endure allow the best evidence to realize EBP (Richardson, 2009). Analyzing present issues in nursing connected to evidence based practices for ICU delirium, a nurse should have the capability to identify certain steps in making a well-rounded clinical question that is structured and focusesd on the key features to help complete evidence based practice DS Dr. Sullivan Your introductory paragraph is good but you could make it better by including one sentence that clearly defines the purpose of the paper. This is usually the last sentence in the introductory paragraph.
.
Developing a research problem is a creative process (Polit and Beck, 2012, p.76). Neuro-trauma ICU patients typically have an increased need for sleep. However, the ICU setting predisposes ICU patients to sleep deprivation due to exposure to bright lights, high noise levels, regular intrusion of staff and visitors, and patient care activities. Current evidence suggests that a relationship exists among sleep, delirium, and mortality DS Dr. Sullivan Use of resources or references would have added credibility to your discussion
. Delirium is commonly linked to higher medical costs, increased risk for death and extended stays DS Dr. Sullivan Need a citation . There has not been a direct link between lack of sleep and delirium has yet to be proven. Current knowledge that sleep deprivation affects cognitive function, points to a very direct connection between the two. Extended hospital stays, increased medical costs, and high risk for mortality have been associated with delirium DS Dr. Sullivan Need a citation . Nurses can assist with decreasing the incidence delirium in ICU patients by using simple methods and hence help improve health outcomes. Some of these methods include turning off lights or dimming them, reducing noise levels, reducing the number of visits/intrusions, proper positioning of ...
Pulmonary medicine- Scope and Future by Dr. Jebin Abraham, MD.Jebin Abraham
Pulmonary Medicine is a branch of medicine that deals with respiratory diseases, chest wall diseases, sleep disorders, allergy and much more. This presentation describes this specialty branch in detail with scope and current perspectives being emphasized. It will help in PG aspirant medicos, academicians and undergraduate students to know about Pulmonary Medicine in detail.
Tweet Your Pubs: How Altmetrics are Changing the Way We Measure Research ImpactRobin Featherstone
Presentation given to the Northern Alberta Health Libraries Association (NAHLA) Trends Mini Conference in Edmonton at the University of Alberta on May 2, 2014
Workshop given at the Medical Library Association Conference in Seattle WA, May 24th, 2012. This course is part of the Medical Library Association's Disaster Information Specialization Program.
Workshop - Disaster Health Information Sources: The BasicsRobin Featherstone
Continuing Education workshop given at the Midcontinental Medical Library Association (MLA) Chapter Meeting in St Louis Missouri on September 21, 2011. Disaster Health Information Sources: The Basics is the foundational class in MLA's Disaster Information Specialization. For more info, see: http://www.mlanet.org/education/dis/
Webinar - Disaster Health Information Sources: The BasicsRobin Featherstone
Webinar workshop given on September 14th and 15th to members of the Medical Library Association (MLA). Disaster Health Information Sources: The Basics is the foundational course in MLA's Disaster Information Specialization. For more info see: http://www.mlanet.org/education/dis/
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Finding Medical Information
1. Clicker Test – Do you think patients
should be able to view doctors’ notes?
1. Definitely, yes
2. Absolutely no
3. Maybe… it depends
Delbanco T, Walker J, Bell SK, Darer JD, Elmore JG, Farag N, Feldman HJ, Mejilla R, Ngo L, Ralston JD, Ross SE,
Trivedi N, Vodicka E, Leveille SG. Inviting Patients to Read Their Doctors' Notes: A Quasi-experimental Study
and a Look Ahead. Ann Intern Med. 2012 Oct 2;157(7):461-70. doi: 10.7326/0003-4819-157-7-201210020-
00002. PubMed PMID: 23027317.
http://www.ncbi.nlm.nih.gov/pubmed/23027317
2. Finding Medical Information
Basis of Medicine, Unit 2, October 2012
Robin Featherstone, MLIS
Liaison Librarian (Medicine)
robin.featherstone@mcgill.ca
3. Where would you go first to find
information about asthma therapies?
1. Cochrane Database of Systematic Reviews
2. Expert opinion
3. Facebook
4. Google
5. Google Scholar
6. PubMed
7. MedlinePlus
8. Textbooks (i.e., Harrison’s)
9. UpToDate
10. Other
4. In 1995, where would you go first to find
information about asthma therapies?
1. Cochrane Database of Systematic Reviews
2. Expert opinion
3. Facebook
4. Google
5. Google Scholar
6. PubMed
7. MedlinePlus
8. Textbooks (i.e., Harrison’s)
9. UpToDate
10. Other
5. Objectives
By the end of this lecture, you will be
able to:
1.Differentiate between filtered and
unfiltered information
2.Describe the difference between
background and foreground questions
3.Begin to identify the best sources to
answer medical questions
6. Less time
Less work
Less evidence
Filtered
Filtered
Unfiltered
Unfiltered
Expert Opinion
More time
More work
More evidence
7. What are the
bronchodilatory effects
of combined inhaled
budesonide/formoterol
and
budesonide/salbutamol
in acute asthma?
Foreground
questions
What are the signs of an
asthma attack?
Background
questions
What is the pathology of
asthma?
Novice Expert
8. A 25 year-old female has been recently diagnosed with
classical Hodgkin’s lymphoma (nodular sclerosing subtype).
Staging reveals that she is a stage IIA with a 4.5 cm nodal
mass in her neck and mediastinal nodes. Her hematologist
recommends combined modality therapy
(chemotherapy/radiation therapy). The patient has done
some reading about therapy and is worried about the long
term effects of radiation especially the risk of breast cancer.
Background Foreground
9. What is the pathophysiology of
Hodgkin’s lymphoma?
Background Foreground
10. For a 25 year old female with stage IIA
Hodgkin’s lymphoma, is combined
modality therapy superior to
chemotherapy alone?
Background Foreground
11. A 35 year-old patients presents to the ER with a right leg swelling
x 3 days. The patient recently returned from a business trip in
Malasia and therefore you suspect a deep vein thrombosis (DVT).
It is the weekend and so the patient receives a CT angiogram that
does not reveal any pulmonary embolism and the venous portion
of the study does not reveal any above or below knee clots. That
said, you are still convinced that the patient may have a lower
limb DVT and so you ask for a lower limb doppler which requires
the radiologist to come into the hospital in the middle of the
night to perform the study. The radiologist is reluctant to come as
the venous phase of the CT angiogram was negative.
Background Foreground
13. Which of the following is more sensitive
for detecting lower limb DVTs (both above
and below knees): venous dopplers or CT
angiograms?
Background Foreground
15. Answers Background questions
Audience Everyone
Compare to WebMD
Contents Filtered information
Cost Free
URL http://www.nlm.nih.gov/
medlineplus/
16. HARRISON’S PRINCIPLES OF INTERNAL
MEDICINE (AKA Harrison’s Online)
Answers Background questions
Audience Novice and expert
Compare to Goldman’s Cecil Medicine
Contents Filtered information
Cost Institutional subscription
URL http://bit.ly/harrisonsonline
17. Answers Background and foreground
questions
Audience Novice and expert
Compare to Harrison’s or DynaMed
Contents Filtered & unfiltered information
Cost Institutional subscription
URL http://bit.ly/uptodatemcgill
18. Answers Foreground questions
Audience Experts
Compare to MetaLib
Contents Unfiltered information
Cost Free
URL http://scholar.google.ca/
19. Answers Foreground questions
Audience Experts
Compare to EMBASE
Contents Unfiltered information
Cost Free
URL http://www.ncbi.nlm.nih.gov/pubm
ed
20. Answers Foreground questions
Audience Experts
Compare to DARE
Contents Filtered information
Cost Institutional subscription
URL http://bit.ly/cochranemcgill
21. Which tool contains the answer to the
question: What is the treatment for
Hodgkin’s disease?
1. Google Scholar
2. Harrison’s Online
3. MedlinePlus
4. PubMed
5. UpToDate
6. 1 OR 4
7. 2 OR 3 OR 5
22. What kind of information does
EMBASE contain?
1. Filtered
2. Unfiltered
3. Don’t know
23. What kind of question is this: Is written or video
educational interventions more effective at increasing
vaccination intention rates in young adults?
1. Background
2. Foreground
3. Don’t know
25. Less time
Less work
Less evidence
Filtered
Filtered
Unfiltered
Unfiltered
Expert Opinion
More time
More work
More evidence
26. Labs
Groups A, D & G Groups B, E & H Groups C, F & I
Mon Oct 22 Tues Oct 23 Weds Oct 24
12:35 pm – 2:25 pm 12:35 pm – 2:25 pm 9:35 am – 11:25 am
Cybertheque, Redpath Redpath e-classroom, Rm 409, McIntyre (2nd
Library Basement Rm 23 floor, Life Sciences
Library)
Assignment
Take home searching exercises
Due: 5 pm on Tues, Oct 30
Submit to the Dean’s Office, 6th floor of McIntyre
27. Questions
Robin Featherstone, MLIS
Liaison Librarian (Medicine)
robin.featherstone@mcgill.ca
Editor's Notes
First of three lectures on medical information Unit 2 – General overview of medical information tools and PubMed searching labs Unit 8 – Pharmacology Resources & RefWorks training
Cochrane: first available on the web in 1996 Facebook: known then as “The Facebook” – launched in 2004 Google: Larry Page and Sergey Brin had only just met at Stanford. They begin collaborating on their search engine, then known as “ BackRub ” in 1996 Google Scholar: released in Beta in 2004 MedlinePlus: consumer website launched in 1998 PubMed: while the index called Medline has been around since the 1970s , PubMed (the searchable web interface) was first released in 1996 UpToDate: Bud Rose’s single-author nephrology textbook went online in the early 1990s. Arguably the first modern medical textbook: Principles and Practice of Medicine – 1892 Key point: There are at least 7 new revolutionary tools for finding medical information invented within the last 18 years. Many of the attending staff at the MUHC and clinical faculty at McGill have been practicing medicine for 20 years at least.
This is a highly simplified diagram of the medical literature. We’ll learn a lot more about the “levels of evidence” for medical information in January of 2014, right before you start clerkship. But, for an overview, it’s important to recognize the difference between filtered and unfiltered information. If a piece of information is “filtered,” that means an expert has collected many individual studies or opinions and created a summary. If a piece of information is unfiltered, it is either one single study or one person’s opinion. Information tools can be distinguished by the amount and the quality of unfiltered or filtered information they contain.
Another useful way we can distinguish information is by the kind of questions that it answers. Medical questions can be either background question or foreground questions Background questions tend to be broad and we ask them to learn more about the fundamental aspects of a disease or topic. Background questions are commonly asked on MCCQEs. The answers to background questions may not be widely known, but they are considered common knowledge. For example… What are the signs of an asthma attack? Foreground questions tend to be narrow or specific, and we ask them to learn more about a particular case. The kinds of questions which will arise during patient encounters will most likely be foreground. For example… What are the bronchodilatory effects of combined budesonide formoterol and budesonide salbutamol in acute asthma? During the first two years of medical school, you’ll be asking mostly background questions. As you move into the clinical environment, you’ll start asking more and more foreground questions.
Clinical scenarios, like this hematology case study will contain both kinds of questions. Sometimes you may have to answer a combination of background and foreground questions. Or you may have to answer a background question before you can address a foreground question.
So, in this case, there is the background question: What is the pathophysiology of Hodgkin’s lymphoma?
And then the foreground question related to treatment: Is combined modality therapy superior to chemotherapy alone? Or another foreground question could be: do the risks of developing breast cancer outweigh the benefits of combined modality therapy? There can be many questions in a single scenario
Before we talk about the information tools which best answer each type of question, can you please read this scenario. With your neighbour, discuss the case and write down one foreground and one background question.
Key point: Information sources for answering background questions tend to all be filtered. When answering foreground questions, you will find use a mix of unfiltered and filtered tools. Obviously, start with filtered tools and then look at individual studies. It all depends on how specific your question is.
Which resource will answer this question? Answer: 7 – 1 OR 3 OR 5 Why? These are all filtered sources for answering background questions
Remember: EMBASE is a database of individual articles, like PubMed. Answer 2 – it contains individual studies, which are unfiltered
After the poll: ask the class > Where would you look to answer this question? Answer: 2 – Foreground question – best answered with an individual study – these are answered in tools like PubMed
Key point: Information sources for answering background questions tend to all be filtered. When answering foreground questions, you will find use a mix of unfiltered and filtered tools. Obviously, start with filtered tools and then look at individual studies. It all depends on how specific your question is.