“When people take medicine at home, mistakes happen.” That’s the start of a recent article on NPR’s web site, citing a new study that found that levels of medication errors are rising, and that most mistakes were preventable. The researchers used information from U.S. poison control centers, and looked only at errors that happened outside of health care facilities. Another study, cited in The New York Times, found that almost 85% of parents give children the wrong dose of liquid medicines, and more than 2 in 3 of those mistakes are overdoses. What is behind these errors, and the increase in their numbers?
Part of the problem is that with increasing levels of conditions such as cardiovascular disease and diabetes, there are more people taking medications for them and therefore more chance of error. Another part of the problem is that the units on the prescription (say, milliliters) may not match the units on the measuring device (say, teaspoons); the researchers on parents and liquid medicines found that simply giving parents oral syringes made a huge difference. Furthermore, as medical care becomes more complex, the home care does too. And sometimes it’s been complex all along; consider the calculations that diabetics must make to calculate their insulin, shown in the potentially daunting chart below.
What can we do to decrease the chance of errors? There are several things for starters! One is to READ THE LABELS. Even pharmacies may make errors (cue the recent story of the man who received and took a yeast infection medication rather than a medication for his hiatal hernia—he didn’t look at the bottle BEFORE starting his course). Another is to KEEP MEDICATIONS AWAY FROM KIDS. Safe storage can avoid quite a few dangerous situations! This includes child-resistant packaging. Caregivers (of children, older adults, or anyone) should MONITOR MEDICATION USE –it’s easy to make mistakes, and two brains are better than one! Parents and caregivers should write down when doses have been given, to avoid double doses. And, perhaps most importantly, ASK QUESTIONS! Many of us rush through the part where the pharmacist asks us if we have any questions about our medications, but we should be asking about any of the following that we aren’t sure of:
- What is the brand or generic name of the medication?
- What is the medication supposed to do? How long will it be until I see results?
- What is the dose? How long should I take it?
- What should I do if I miss a dose?
- What should I do if I accidentally take more than the recommended dose?
- Are there any foods, drinks, other medications or activities I should avoid while taking this medicine?
- What are the possible side effects? What should I do if they occur?
- Will this new medication interfere with my other medication(s)? If so, how?
These are just a few of the many ways we can protect ourselves from making mistakes when taking medications; consider them, look for other ideas if you feel moved to, and be safe out there!
Photo credit: Pinsker et al., 2013
It’s World Vegan Month, and as the PNR’s only vegan, I thought I would take the opportunity to post about this little known celebration. It has always struck me as odd that World Vegan Month should fall during Thanksgiving, a holiday renown for the consumption of vast amounts of turkey and ham. But then again, the vast majority of Americans are not vegan.
What are vegans? MeSH defines them as “persons who avoid consuming animal products or animal-derived substances, such as MEAT; EGGS; or HONEY. Some vegans also refrain from using animals or animal products in any form or for any purpose, such as in CLOTHING or household goods. (Year introduced: 2016).” It is quite telling that this subject heading was just added in 2016. Veganism and plant-based eating are becoming a “thing.” More and more research is pointing to the benefit of eschewing animal products and adopting a diet that is organic, plant-based, minimally processed, and easier on the environment. According to the Permanente Journal’s “Nutritional Update for Physicians: Plant-Based Diets, ”research shows that plant-based diets are cost-effective, low-risk interventions that may lower body mass index, blood pressure, HbA1C, and cholesterol levels. They may also reduce the number of medications needed to treat chronic diseases and lower ischemic heart disease mortality rates. Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.” And that’s saying a lot, considering the fact that physicians haven’t been known for racking up a lot hours of nutrition education in medical school. The Academy of Nutrition and Dietetics has recently published a position paper on vegetarian diets and it also highlights the mounting evidence for adopting this lifestyle, including the environmental sustainability of diets rich in plants, as opposed to resource depleting animal products.
The plant-based movement is growing. The Plant Based Food Association and The Good Food Institute recently released new data which indicates an 8.1 percent growth in plant-based food sales since last year. And Baum and Whiteman, an international food and restaurant consultant, called plant-based dining 2018’s trend of the year. More and more meat free choices are becoming available in local groceries and restaurants. No longer are we relegated to eating from just the salad bar.
Thinking of giving this vegan thing a try? Keep in mind that you can be just as unhealthy a vegan as an omnivore. Potato chips and soda are vegan, after all. For guidance on vegetarian, including vegan diets, MedlinePlus offers a variety of useful links. And as I mentioned above, PubMed now includes a MeSH term for this dietary practice. In addition to NLM links above, I’d like to offer some additional resources that I have found both useful and evidence focused.
Happy Healthy Long Life: A Medical Librarian’s Adventures in Evidence-based Living
The Vegetarian Resource Group
It Doesn’t Taste Like Chicken
My own journey towards veganism started many years ago when I decided to experiment with a vegetarian and then vegan diet. Over the years, I shifted back a forth from vegan to lacto-ovo-vegetarian to pescatarian, but it was the reccurrence of an autoimmune disorder I had suffered from in my early twenties that convinced me to return to a plant-based, minimally processed diet. Both my family physician and my rheumatologist were in awe of how quickly my dietary choice lead to a remission of my symptoms, and a return to normal health. I’m vegan to stay.
While I don’t necessarily expect you to skip the turkey or ham this Thanksgiving, I do hope this post will give you some food for thought. I also hope you will add your comments below if this post has encouraged you to explore plant-based eating further, or if you’ve already decided to become an herbivore. Happy Thanksgiving! But please, don’t pass the Tofurky.
The next PNR Rendezvous webinar for November is coming soon.
When: Wednesday, November 15 starting at Noon Alaska, 1:00pm PT, 2:00pm MT
Title: HRSA’s Resources and Initiatives for Native American Communities
Gary Gant, from the Health Resources and Services Administration’s Office of Regional Operations for Region 10, will share some of his office’s initiatives and activities within the Native American community as it pertains to behavioral health, chronic disease, education, human trafficking and substance abuse.
Eligible for 1 Medical Library Association (MLA) CE credit for attending the live session or viewing the recording.
Please join us for this wonderful opportunity to learn about the important work that HRSA provides.
For more information about this session and how to connect please visit the PNR Rendezvous webpage
It’s time for another PNR Twitter Chat. This time it’s PNR Day on Twitter. Using the hashtag #nnlmpnrchat, drop by at any time on Thursday, November 16, to give us your input. Include #nnlmpnrchat in your tweet. Unsure how this all works? See Twitter Chat 101 for more information. PNR staff will monitor the conversation and ask questions throughout the day, but we are interested in hearing from you on topics such as:
- What interesting topics or trends would you like the PNR to explore?
- How do you like to learn about health topics? Webinars, Moodle classes (asynchronous), tutorials?
- Is MLA CE credit important to you?
- How can we serve you better?
- What is your preferred communication format? (e.g. blog posts, email, newsletters).
Remember, it’s fine to be a lurker. If you just want to see what it’s all about, sign up for a Twitter account and take a look. You don’t have to say anything, but you may find something you like. Twitter’s use as an educational tool is growing. Please join us on Twitter for a few minutes or longer, any time on November 16. Search for #nnlmpnrchat to see what we’re up to.
Our last Twitter chat, in March, featured PNR Research & Data Coordinators Ann Glusker and Ann Madhavan. For a transcript of that chat, see: https://news.nnlm.gov/pnr/nnlm-pnr-twitter-chat/
The National Network of Libraries of Medicine (NNLM) and the Public Library Association (PLA) are partnering to bring health and wellness to the library. This new nationwide initiative will assess the health information needs of public libraries and provide opportunities for public library staff to increase their knowledge and confidence regarding consumer health services and programming.
One such professional development opportunity is a 1 day pre-conference at PLA 2018. Stand Up for Health: Health & Wellness Services for Your Community is Tuesday March 20, 2018 from 9:00am – 5:00pm.
PLA is offering a limited number of stipends worth $500 to cover registration and some travel costs for this pre-conference session. This opportunity is open to librarians, including library support staff and paraprofessionals at libraries in the U.S. and U.S. territories.
Also, those who take the class and complete some pre/post work will receive a certificate for level 1 of the Consumer Health Information Specialization (CHIS) through the Medical Library Association (MLA) at no cost, sponsored by NNLM.
Applications for the pre-conference stipends are now being accepted with the deadline of November 19. Read the stipend opportunity guidelines, read the Frequently Asked Questions and start your online application.
Want to learn more about the Consumer Health Information Specialization and its benefits? Attend a free webinar this Wednesday, November 1 from 11:00am – Noon PT. Register to attend, Putting the Consumer Health Information Specialization to Work in Public Libraries. Unable to make it? The session will be recorded and available a few days later.
To celebrate Medical Librarian’s Month we have invited medical librarians in our region to submit some information about who they are and the work that they do as medical librarians.
Today we are ending our series with a post from an independent medical librarian in Washington!
Who am I? Julia Parker, M.S., M.L.I.S
Where do I work? Biosleuth Consulting Services, LLC
Unlike many of my colleagues, I work as an Independent Medical Librarian . . . a liaison to people of diverse information needs, not necessarily local to WA. I am the principal of Biosleuth Consulting Services, LLC. I work out of my home a great deal of the time . . . or am one of those people you see working on their laptops in local coffee shops.
How I came to be the Biosleuth
I never intended to become a librarian, though I have loved to read and sit in libraries since grade school. Although my professional journey has been quite circuitous, the road traveled has provided me the experience base for all I am asked to do as a consultant. I started undergrad with the intention of becoming a Veterinarian, and by the time I graduated, I decided I wanted to be a researcher. I worked in labs for a while and then returned to Grad school. My career path veered between the time I obtained an M.S. and was pursuing a Ph.D. in Pathobiology. I decided what I really wanted to do was spend my time searching for critical medical and scientific information. That’s when I applied to the UW’s program for my M.L.I.S. I gained practical experience, while in school, by volunteering in 2 medical libraries, doing an internship at the local public library, enhancing subject headings in the in-house catalog at a local biotech as my student project and working part-time on UW’s HealthLinks. Once armed with my new tools, I was so fortunate that a small biotech hired me to run their corporate library. I became active in SLA, and WMLA and have served on committees and boards for both organizations ever since. What I was unprepared for has been the volatile nature not only of the biotech scene in Seattle, but for libraries, as well. Three lay-offs later, I decided to launch my business as an independent.
Over the past 8 years, I have continued expanding my network; I’m a staunch believer in LinkedIn. AIIP (Association of Independent Information Professionals) helps promote my business through their online member directory, provides me access to critical search tools, such as STN and Dialog (at a discounted rate) and has monthly webinars given by other members or vendors. In fact, the example set by a couple AIIP’ers is what originally inspired me to go independent. I count my large network of professional colleagues and peers one of my very best assets.
The majority of my projects are reviews of the published literature (medical, scientific and/or patents) on a specific topic for large corporate entities – either as part of due diligence for marketed products or when considering a new direction. I might be asked to digest and summarize the research, then present the significance of the work to executives and marketing directors. In 2014, I was approached by a friend who had a recent medical diagnosis she was finally beginning to deal with, both physically and emotionally. I agreed to co-author a book, which we published two years later entitled, Beyond Embarrassment : Reclaiming Your Life with Neurogenic Bladder and Bowel. I learned a lot along the way, including what it takes to bring a book to print and I continue working with my friend on her blog, TrudyTriumph. The blog gives us a chance to educate and encourage those living with continence health issues – a community to which patients can turn, when they want to talk to others who have similar experiences.
I’m back in a Library!
This past year I was hired to help set up a new Business Library for the non-profit organization, Life Science Washington, which provides resources and networking opportunities for Washington state biotechnology and medical device companies. I provide monthly consulting appointments to help these small-business members utilize tools they wouldn’t have licensed as individuals or small corporations. Since the vast majority of my consultant work is done remotely, I relish these reference/training hours in which I have actual face-time with executives who represent the future of medical science. They are the ones who inspire me, if I occasionally stop to wonder if what I do is of value!
To celebrate Medical Librarian’s Month we have invited medical librarians in our region to submit some information about who they are and the work that they do as medical librarians.
Today we hear from a hospital librarian in Oregon!
Who am I? Judith Hayes, MLS
Where do I work? Tuality Healthcare in Hillsboro, OR
I started work as a medical librarian at Tuality Healthcare in Hillsboro, OR, on April 15, 1994. Almost 24 years later, I am approaching retirement in just a few short weeks with anticipation and dread.
It’s been amazing. I have loved my job. It feeds my sense of satisfaction to find just the right piece of information for someone: so a patient can gain understanding about their disease and talk with some knowledge with their provider, so a provider can receive the latest evidence-based information in minutes for patient treatment, so a teacher can hold an anatomy fair with hands-on stations to spark a light for science and medicine in a student, so library school student volunteers and assistants can end up with fabulous jobs all over the country.
I feel blessed to have been at an organization that prized personal growth and allowed an enormous amount of autonomy to library staff. If there was a project we wanted to do, there was a way to make it happen, with grants from the RML for Outreach (thank you, RML!), the local City of Hillsboro for educational chats on health topics partnering with public libraries, Tuality’s Foundation for bankrolling the public portion of the library, local Librarian organizations for speaking and teaching opportunities (thank you OHSLA, PNC, Oregon State Library Association, Washington County Public Libraries and Tuality!). I’ve had the opportunity to share my knowledge with doctors, nurses, public reference librarians, teachers, students, and members of the public, both in the library and outside of it.
Several people stand out.
- There was a young man who came in having received a devastating diagnosis. Together, we found information about his rare disease and talked about some surgical options in the area. He returned months later to say thank you because I was the first person who had given him any hope that he would have a future.
- There was a young mother who came in on the day she was having diagnostic tests to determine why she was ill. The second visit was to look for possible treatment information about a specific diagnosis, the third to search for information about dealing with side effects, and the fourth to return all the borrowed materials. Treatment was over and she was well.
- The grandfather trying to help the teenage granddaughter who had just come to live with him. The new mother researching heart surgery treatment for her baby born with congenital heart defects (an article about the successful series of surgeries appeared in a local paper months later). The pharmacist who needed the latest drug dosages to treat a patient in 10 minutes. The nurse working on protocols to update nursing staff. The request from a surgeon friend in Africa wanting to know if his treatment of a disease was really still the best way to do it. Designing a CME series of four classes and discovering that yes, we had data to prove that the education had improved patient outcomes.
My philosophy has been to say “yes” whenever possible. That helped me to stretch into new ideas and skills, and made the library a place to find answers and help, and not be turned away. That means I am a proctor of tests, publicist of classes, book editor, instructor, CME coordinator, grant writer, data analyzer, mentor to library school student volunteers, library page, and oh, yes, researcher.
It’s been a great adventure. Thank you to everyone in the region who helped make it possible. The support in the Pacific Northwest has made this a GREAT region to work with.
I would like to acknowledge the Urban Indian Health Institute’s enormous contribution to today’s blog! — Annie
In past blog posts, we have explored health literacy issues from a variety of perspectives. Today we explore how it impacts American Indians and Alaska Natives (AI/ANs). According to the Indian Health Service, “low health literacy is disproportionately burdensome to American Indians and Alaska Natives and their elders.”2 Individuals with lower health literacy skills often use more health care services designed to treat disease complications, while fewer use services intended to prevent complications. Because health literacy is closely linked to poverty, AI/ANs are disproportionately impacted. According to the 2016 American Community Survey, the median household income of AI/ANs was $39,719 (+/-1,029)3, compared to $59,039 for the total population and 26% of single-race AI/ANs experienced poverty, compared to 14% of the nation as a whole.
American Indians and Alaska Natives have historically experienced significant health disparities compared to other Americans, leading to lower life expectancy and greater disease burden. The leading causes of death for AI/ANs include diseases of the heart, malignant neoplasm, unintentional injuries, and diabetes. Governmental policies, institutional practices, and systemic oppression of cultural teachings have shaped the current conditions by which AI/ANs experience racially disparate outcomes in educational attainment, economic outcomes, and access to health care services, including culturally relevant health literacy. All of which contribute to higher rates of chronic diseases among AI/ANs.
The Centers for Disease Control and Prevention (CDC) is one government agency supporting culturally adapted health literacy models led by and for AI/ANs. Between 2014-2019, the CDC will invest $78 million in chronic disease prevention efforts through the Good Health and Wellness in Indian Country (GHWIC) initiative. Increasing health literacy as one of five GHWIC goals. The GHWIC initiative is unique because it promotes revitalization of indigenous values and traditional knowledge.
Annually, over 100 tribes and tribal organizations craft community driven health promotion strategies based on local norms and cultural values. These culturally adapted and community responsive strategies aim to combat the higher rates of chronic disease experienced by AI/ANs. Since 2014, GHWIC-funded communities have adapted health promotion materials, trained medical providers in culturally competent care practices, and promoted community-based prevention models.
For example, GHWIC-funded communities have used cultural adaptations of tobacco prevention and management models to reduce commercial tobacco use and exposure to secondhand smoke. Commercial tobacco is the single most preventable cause of disease, disability, and death for AI/ANs. With the support of GHWIC, tribes and tribal organizations craft health promotion materials, coordinate media campaigns, and implement smoke-free policies to address and reverse the impact of commercial tobacco use while distinguishing and reclaiming the role of traditional tobacco. Through this multi-pronged and collaborative approach, GHWIC-funded communities ensure that health literacy is culturally appropriate and relevant to their communities.
Learn more about culturally relevant health literacy efforts by visiting the GHWIC Interactive Storymap.
The Indian Health Service (IHS) provides another example of a government agency working to eliminate health disparities in AI/AN communities. The IHS mission is to “raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level,” and health literacy is one component of improving health quality and health communication. The IHS website offers guidance to health care providers on how to improve health literacy by adapting health literacy tools for providing culturally sensitive care.
Check out the IHS “October is National Health Literacy Month” announcement for more information on the how they are addressing this issue, and check out Alberta Becenti’s (Navajo) blog, “Health Literacy Month Brings Attention to Importance of Delivering Clear Information to Patients” on how to “Be a Health Literacy Hero.”
- U.S. Department of Health and Human Services. 2000. Healthy People 2010. Washington, DC: U.S. Government Printing Office. Originally developed for Ratzan SC, Parker RM. 2000. Introduction. In National Library of Medicine Current Bibliographies in Medicine: Health Literacy. Selden CR, Zorn M, Ratzan SC, Parker RM, Editors. NLM Pub. No. CBM 2000-1. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services.
- Indian Health Service Health Literacy Workgroup. Indian Health Service: White Paper on Health Literacy, August 2009 https://www.ihs.gov/healthcommunications/includes/themes/newihstheme/display_objects/documents/IHSHealthLiteracyWhitePaper.pdf
- American Community Survey, 1-Year Estimates, 2016. S0201 – Select Population Profile in the United States https://factfinder.census.gov
- U.S. Census Bureau. Current Population Reports. Income and Poverty in the United States: 2016. https://www.census.gov/content/dam/Census/library/publications/2017/demo/P60-259.pdf
To celebrate Medical Librarian’s Month we have invited medical librarians in our region to submit some information about who they are and the work that they do as medical librarians.
Today we hear from a health sciences librarian in Montana!
Who am I? Sheila Bonnand, Research & Instruction Librarian
Where do I work? Montana State University Library, Bozeman, Montana
What is it I do? I can’t describe a typical ‘day in the life’ because the work I do as an academic librarian is so very varied – and the last six months have been even more atypical. Why? During that time, I was often on the road, driving over 3000 miles across our amazing state with my colleague, Mary Anne Hansen, visiting Montana’s seven tribal college libraries as well as four MSU-College of Nursing sites.
Mary Anne and I are our library’s health sciences librarians. As such, one of our important partnerships is with the College of Nursing (CON). The CON focuses on evidence-based nursing so does not need to be convinced of the importance of the library and librarians; we work regularly with classes as well as with individual faculty and students on information literacy efforts.
The College, however, comes with a big challenge: it is a multi-campus program. There is no community in the state big enough to provide the number of clinical placements needed. Because of this, in addition to the main campus in Bozeman, there are CON branches in Billings, Great Falls, Kalispell, and Missoula.
In order to address the distributed nature of the program, MSU library invested early in using online tools to reach faculty and students. Mary Anne and I have been teaching library instruction sessions via web conferencing for a number of years and also use it for one-on-one research consultations. As helpful as web conferencing and other online communications are to keep in touch with our CON students and faculty, over the years we’ve become convinced that face-to-face contact is equally as important. We also think our work needs to be informed by knowledge about the CON branch campuses. This was our impetus to apply for an NNLM PNR community outreach grant – we wanted to be able to meet busy CON faculty and students where they are and connect in a more personal way. Hence days on the road and miles racked up! Our final trip ended on September 22.
What have been some of the outcomes so far from these in-person visits to our CON campuses? Definitely some intangibles – we heard from folks on each campus how happy they were that we made the effort to visit their facilities. We also heard questions starting with “‘I meant to email you about this …’ But we’ve also started to see some tangible results. For example, we were already invited to meet via web conferencing with Kalispell faculty who couldn’t make our in-person meeting. While on site in Billings, the director there extended an invitation to return to Billings meet with 180+ students at their January orientation. We’ve been contacted by students at these locations for research consultations (and they mentioned meeting us while we were on their campuses). We strengthened collaborations with local librarians who also work with CON students by inviting, for example, our colleagues at Great Falls College join us in a joint presentation to nursing faculty about services available at both of our libraries. We anticipate further positive results over the course of the school year.
We are so privileged to be able to get the support to do this work. Thanks, NNLM PNR! Now about our visits to the seven tribal college libraries – you’ll have to join us for our PNR Partners webinar on October 31!
Part 3 of our Health Literacy Month series —
Universal Precautions is a concept in medicine aimed at preventing the transmission of bloodborne infections. The idea is to assume infection could be present and take the needed precautions at all times. These steps are incorporated into the objectives of a program and made a part of training and implementation of policies designed to prevent the inadvertent transmission of infection.
Likewise, health literacy can be approached from a universal precautions standpoint. Experts recommend assuming that everyone may have difficulty understanding medical information and instructions from their healthcare provider. The U.S. Department of Health & Human Services Agency for Healthcare Research and Quality (AHRQ) recommends a Universal Precautions approach:
Health literacy universal precautions are the steps that practices take when they assume that all patients may have difficulty comprehending health information and accessing health services. Health literacy universal precautions are aimed at —
- Simplifying communication with and confirming comprehension for all patients, so that the risk of miscommunication is minimized.
- Making the office environment and health care system easier to navigate.
- Supporting patients’ efforts to improve their health.
Low health literacy can result in medication errors, hospital readmissions, lack of preventive care, increased us of emergency rooms, and poorer health outcome overall. Clear communication is the responsibility of the healthcare system, including organizations and individual clinicians. The AHRQ provides a free Health Literacy Universal Precautions Toolkit to help primary care providers increase patient understanding of health information.
The National Library of Medicine’s MedlinePlus can also assist with educating patients and families and enhancing communication with healthcare providers. The site is available in English and Spanish and provides up to date information designed for the lay person to understand.
Today we hear from a hospital librarian in Idaho!
Who am I? Karly Vesely, MLIS
Where do I work? Health Sciences Librarian at Kootenai Health in Coeur d’Alene, Idaho
Why do I love my job? I was talking about the Kootenai Health Medical Library to a group of new employees, and one of them remarked that I clearly love my job. I really do, and here are a few reasons why:
- Fun! Fun is my number one motivator at work, and in life in general, so I love that my job allows me to come in and have fun each day. As a hospital librarian, I have a fair amount of autonomy, and that allows to me to incorporate my sense of humor and enthusiasm in to most of what I do!
- Rewarding! Employees here at Kootenai love their library and its services, and it shows! I’m so grateful for the amazing feedback I get: “Thank you to the moon and back for all the articles you dug up for me!!!”; “Can I just say…You’re the best!!! Thanks a million”; “These articles look awesome so far! Thanks for your help!”. Who wouldn’t like their job with that kind of encouragement?
- Investigative! Being a hospital librarian allows me to exercise my natural curiosity and thirst for knowledge with every literature search and clinical question I receive! I can’t rest until I’ve hunted down the answer to the best of my ability.
- Varied! As a solo librarian, I get to do a little bit of everything – literature searching, collection development, electronic resource management, circulation, document delivery, interlibrary loan, etc. AND I get to work with so many different groups across the hospital – physicians, nurses, therapists, administration, etc. I love the variety!
- Dynamic! With technology constantly changing, I’m never bored. I love exploring emerging technologies and I’m not afraid to tackle something new. Having a software engineer for a husband helps with that too;).
Final note? I think one of the biggest misconceptions about being a medical librarian is that we spend most of our time checking out books. I think a lot of people outside the library world would be surprised that in the last week alone I’ve:
- Completed 9 literature search requests
- Set up and presented trials of several online nursing resources to our Nurse Educator group
- Met one on one with a couple of physicians for new Medical Staff Orientation
- Had a booth at the new employee General Orientation Resource Fair
- Helped facilitate a physician focus group
- Met one on one with nurse to teach her more about literature searching for her BSN program
- Worked with our Communications and Marketing department on the library’s new website and on updating some unrelated physician handouts
- Held a meeting with our Nursing Research department to discuss a potential Writing and Publishing class to help our nurses with the publication process
- And so much more!
“Copyright & Online Learning Resources: It’s Complicated!” is the next PNR Rendezvous session.
When: October 18 starting at 1:00pm PT, Noon Alaska, 2:00pm MT
Questions about library resources and fair use in online education are expanding from the appropriate use of journal articles and eBooks to published images, video clips and more in faculty-created resources for instruction that our licensing terms often don’t explicitly address. What to do? Join the session as our speaker, Nikki Dettmar, describes ways of supporting the faculty, staff & students of the University of Washington School of Medicine, which launched a new curriculum in Fall 2015 requiring students to self-study resources in online courses ahead of in-person class sessions focused on active learning. Please note this is not intended to be an authoritative copyright presentation or legal advice, but a time of sharing some of the common questions and challenges faced and ways to develop informed decisions and propose solutions to educators.
No registration required. Learn how to connect.
Worth 1 MLA CE for attending the live session or watching the recording.
“Leveraging PubMed Commons for Medical Librarians” is the next PNR Rendezvous session.
When: October 18 starting at 1:00pm PT, Noon Alaska, 2:00pm MT
Medical librarians play an important role in the evaluation and dissemination of credible life/biomedical sciences information. Peer-review is part of this process. However, peer-review is not an infallible process. In an age of open science, there is a need for open review and information exchange opportunities that extend beyond the traditional published formats. Providing a channel and an audience for open post-publication communication is one way to achieve this ideal.
In October 2013, the National Library of Medicine introduced PubMed Commons, a social media pilot program promoting post-publication discourse. The program became an official feature of PubMed in December 2015. Authors whose publications are indexed in PubMed are invited to comment on other authors’ work and participate in open information exchange. Even in its early state, PubMed Commons is impacting the medical library community by providing useful information that reaches beyond traditional metrics and aids in identifying quality, credible medical information. This webinar will update you on what types of conversations are happening on PubMed Commons and provide tips to help you search for PubMed Commons comments in PubMed.
No registration required. Learn how to connect.
Worth 1 MLA CE for attending the live session or watching the recording.
Part 2 of our Health Literacy Month series-
Genetics has become more prominent in the news in recent years. Sometimes it looks like great scientific advancement and other times it can look a little unsettling and seem like something out of science fiction. Genomic health literacy is becoming increasingly important as precision medicine, pharmacogenomics, and direct-to-consumer genetic testing and other genetic associated topics are emerging at the intersection between health and genetics, and consumers need access to information about these and other related topics in a manner that is understandable.
It has been noted that many Americans do not have the genomic literacy levels needed to start comprehending what genetics has to do with health. The general public’s understanding of basic biology especially in regards to genetics and understanding of mathematical concepts in regards to probability theory, risks and statistics is no-where near adequate to where they can comprehend the recent scientific advances and achievements especially in regards to the genomic component. Also, the public needs to consider the role that genomics plays in healthcare decision making, lifestyle changes, family history as well as the social and ethical aspects. If the public cannot understand this then its impact on their health behavior may be little to none. Many people who have lower genomic health literacy may also have low health literacy or low literacy in general.
You may have noticed the use of the words genetics and genomics. These two words are often used interchangeably but they actually mean two different things and this can be confusing. Genetics is the more familiar term. It refers to the study of specific, individual genes and their role in inheritance. Genomics refers to the study of all the genes in an organism. But don’t get too caught up in the semantics. The important thing is to know where to go to get some easy to understand information about genetics.
Whether you work in healthcare and are wanting to provide patients with information about genetics and their health, or at a school wanting to provide educational resources for your students or a librarian who has a patron seeking information about participating in a research study focusing on genetics, it is important to provide appropriate and accurate information.
- GeneEd was developed and is maintained by the National Library of Medicine and National Human Genome Research Institute. This resource is for students and teachers in grades nine to twelve to learn genetics. Links are provided to a variety of resources and learning tools such as experiments, interactive tutorials, games, and research articles enable teachers to reinforce concepts and supplement curricula.
- The National Human Genome Research Institute (NHGRI) is dedicated to the application of genome research to human health, including the ethical, legal, and social implications of genome research. The institute provides an array of information for the public connecting genetic information basics to health through family history, research being done in the field, and disease information. Users will also find information that raises awareness of societal issues such as privacy, discrimination, and regulation of tests. Educators will find links to resources in NIH as well as to other trusted resources, with educational tools for use in the classroom and for students when writing research papers or preparing projects.
- The National Library of Medicine created Genetics Home Reference as a consumer resource to find information about health conditions with a genetic component. This resource is more than just about finding information about specific genetic conditions. The “Help Me Understand Genetics” section provides the basics about genetics for newly diagnosed patients and their families and can be an educational resource to learn about specific genes, chromosomes, and their roles in human health for middle and high school students.
- MedlinePlus includes several health topic pages on genetics-related information such as genetic conditions, genetic testing, and gene therapy. Text-word searching will result in a variety of genetic and genomic-related information. However, specific health condition topic pages can also include a section specifically addressing the genetic aspects of the health condition. Remember, health conditions with a genetic component may or may not include specific developmental disabilities typically associated with genetics.
Today we hear from a hospital librarian in Alaska!
Who am I? Leslie Meyer, Knowledge Navigator
Where do I work? Central Peninsula Hospital’s Health Resource Center in Soldotna, AK
With the official title of Knowledge Navigator, I hear this question at least once a day from patients, friends, and confused members of the general public. While many of them are satisfied with a simple, “I’m a medical librarian,” that answer doesn’t satisfy me, because it doesn’t encompass everything that I do during a day. Not even close!
I staff Central Peninsula Hospital’s Health Resource Center, located on Alaska’s Kenai Peninsula. Although the city of Soldotna and the surrounding areas are considered fairly populated (for this state, anyway), we’re still rural enough that people often have trouble locating resources they can comfortably access. That’s where I come in.
The Resource Center offers books for loan to patients, employees, and anyone in the community. I also handle requests from physicians, nurses, and other medical staff for articles from medical journals. I have pamphlets, LibGuides, and patient workbooks. I have iPads and laptops loaded with health apps and websites available for patients during their admission. I have medical reference journals, I have meditative audio and video guides, I even have a couple of adult coloring books. I’m on steering committees and advisory councils, and I work with people from departments across the entire hospital to be sure that our community members have access to the best information there is.
I also interact directly with patients. Every day I go up to the inpatient floor and ‘round’. Anyone with a new diagnosis is offered a personalized LibGuide specific to their personal and literary needs. This includes everything from local resources to trusted websites, relevant books, and where to find them in the community or online. Our hospital has an open medical record policy, and I often help patients and family members navigate our patient portal, where they can see test results and notes from previous visits. Some people may need help filling out or understanding their Advance Health Care Directives; I break each section down and help them be sure what everything means, and then I notarize it and help them file it. Sometimes, if I have a few minutes, I even sit and chat a little.
So when I say “Knowledge Navigator”, I mean literally just that! I help people navigate through the often-overwhelming world of medical information, so that they can become better advocates for themselves and others. My absolute favorite part of an interaction is helping people become better informed and seeing some of that stress slough off their shoulders. I love it when someone leaves the Resource Center with a list of new websites, or a book about diabetes, or with the number and meeting time of a support group and looking just a little less worried than they were before they came.
Healthcare is scary. But it doesn’t always have to be with the proper resources and education, and I’m very grateful to be a medical librarian, a navigator, and a consumer health specialist with all of you!
This post is the first in our “Health Literacy Month” series happening this month, October 2017
As health care becomes more sophisticated and complex, it’s more and more likely that we will face situations where we have to use numerical skills to figure out our own treatment choices. Our capacity to deal with the numerical component of health information is called “health numeracy” and it’s akin to health literacy, but is not the same thing (people can have high literacy and low numeracy, and you can’t tell by looking what a person’s numeracy level is!). The challenges relating to numeracy are many, and can defeat even people (including health care providers) with the best intentions. According to an article in The New York Times, one study found that almost 85% of parents gave their children the wrong dose of liquid cough medicine, and of those wrong doses, 68% were overdoses. Scary!
So, now, want to learn more?
First, consider attending a FREE online health numeracy class, “Making Sense of Numbers: Understanding Risks and Benefits, and Learning How to Communicate Health Statistics”. It’s by the NNLM’s own Michelle Burda, and it’s a great overview of the topic, and some ways to think about numerical aspects of health.
Second, if you want an overview of how to work with people who may have numeracy challenges, check out this article (coincidentally, by me, and starting on page 28), “Safety in Numbers: Helping People with Health Numeracy Challenges (Which is All of Us)”.
Third, we can talk about best practices around numeracy all we want, but what happens when you are a numeracy expert and yet are faced with your own health challenge which requires you to calculate risks and future possibilities? You will find that it’s not ALL about the numbers! Listen here, to the moving story of Professor Brian Zikmund-Fisher.
And last but not least, take a look at a great tool developed by Dr. Zikmund-Fisher. It’s called IconArray (and there’s a clinician-focused version too!). If you are wanting to show what a certain percentage, or risk, looks like (to anyone, not just someone you think may have limited numeracy!) it takes 30 seconds with this great tool–see the screenshot below.
Do you have any numeracy-related tips or tricks that you want to share? Please enter them in the comments—we’re all in this together!
The Urban Indian Health Institute (UIHI), a Division of the Seattle Indian Health Board located in Seattle, WA is one of 12 tribal epidemiology centers (TECs) funded by the Indian Health Service (IHS). TECs serve as a crucial component of the health care resources for all American Indians and Alaska Natives (AI/AN) by:
Managing public health information systems
Investigating diseases of concern
Managing disease prevention and control programs
Communicating vital health information and resources
Responding to public health emergencies
Coordinating these activities with other public health authorities
Although eleven of the TECs focus on regional AI/AN population health issues in IHS service areas, the UIHI addresses nationwide tribal AI/AN and urban Indian public health and disease surveillance needs. On their website, you will find the data-rich UIHI annual Community Health Profile, an overview of the health status of American Indians and Alaska Natives (AI/AN) within the 33 Urban Indian Health Programs (UIHPs) service areas. They also offer an excellent series of fact sheets, reports, and toolkits on chronic disease, communicable disease, and child and maternal health.
With her team of researchers, UIHI Director, Abigail Echo-Hawk, is passionate about decolonizing AI/AN data. For centuries, tribal information has been collected and interpreted by outside officials, government agencies, and researchers. This has not only led to inaccurate and often harmful outcomes, but is also reflected in the wide gaps in accurate and reliable data available about AI/AN populations and their health trends. One of the overarching goals of the UIHI is to right this wrong and place health data back in the hands of the tribal and urban Indian population, where it can be used to help identify and ameliorate the health disparities that currently exist.
The NNLM PNR is proud to work with the UIHI and we look forward to bringing you more information on the amazing work they are doing.
Open data… big data… data management… These terms swirl around us, and often we just let them flow past. But, to understand and navigate the rapidly changing landscape that is data, we need certain skills, and these are characterized as “data literacy”. One definition of data literacy, from DataPopAlliance.org, is “the desire and ability to constructively engage in society through and about data” (click here if you want to know the thinking behind this and here if you want to see a quick video). But I like this one, from the wonderful Data Journalism Handbook, better:
“Just as literacy refers to “the ability to read for knowledge, write coherently and think critically about printed material”, data-literacy is the ability to consume for knowledge, produce coherently and think critically about data. Data literacy includes statistical literacy but also understanding how to work with large data sets, how they were produced, how to connect various data sets and how to interpret them.”
The graphic here (and at the bottom of this post) is a good representation of how the skill sets needed for data literacy intersect. I think some of us worry that we don’t have the necessary statistical literacy in particular to really feel data-literate, but if you are someone who thrives on orderly arrangements of information—perhaps a library classification system?? –you are fine! Orderliness goes far, as does a critical eye towards credibility, currency, reliability, and all those other good criteria we use to assess information every day. Those are essentially the messages of this piece, “Become Data Literate in Three Steps”.
Which brings me to, why should we care? To answer that question, I commend to you the below quote from a wonderful article which appeared recently in Public Library Quarterly, “Open Data: What It Is and Why You Should Care” (hence the quotation marks in this post’s title!). It’s aimed at librarians, but it has a message for all of us:
“As librarians, we know that data is distilled into information; information is distilled into knowledge; and knowledge drives better decision-making. When librarians help patrons, students, business owners, community members, and public servants harness information, we are helping them make better decisions in their communities, business, and lives…And most importantly, in a time with increasing threats to information and media literacy, where public data is being removed from the public sphere, it is more important than ever to ensure that government-funded and government-derived data remains data of the people, by the people, and for the people.”
Convinced it’s worth learning more about data literacy? For fun, check out the HipHopLibGuide’s Data Literacy page. Because, speaking data-wise, who DOES have the largest Hip Hop vocabulary?
- In 2015 there were 33,091 opioid-related deaths in the US.
- Every day, more than 90 Americans die after overdosing on opioids.
- ER visits and opioid overdose-related deaths have more than quadrupled in the last 15 years.
- September is National Recovery Month.
Join us this Friday for a Twitter chat hosted by the National Institutes of Health (NIH) to discuss opioid use disorder and ways to prevent and treat it.
NIH Director Dr. Francis Collins, NIDA Director Dr. Nora Volkow, NINDS Director Dr. Walter J. Koroshetz, special guest American Society of Addiction Medicine, and several other NIH and HHS components will be responding to questions about the opioid crisis and how the government is working to combat it.
Use #OpioidAwareChat to join and help promote. September 29, 11:00am -Noon PT.
What does the banning or challenging of books tell us about our society?
Banned or challenged books are often books that reflect the diversity of our world. In 2015, of the 10 most challenged books, 9 of them “…contained diverse content.” Many of these books are authored by and/or contain people of color, people who identify as LGBTQIA, people of a different religion, or people with a disability. In other words, people who are minorities or not part of the dominant culture. Readers may become uncomfortable reading about unfamiliar experiences or perspectives. For many, diversity implies negative connotations and therefore are controversial in their eyes despite the fact that many readers may at long last feel a great connection and empowerment when reading these books.
ALA had over 300 challenges in 2016 alone, with an increase of 17% from 2015 which may also be due to a more streamlined reporting system. Nevertheless, half of the top 10 books most challenged in 2016 were removed where they were contested. This was a significant increase from the average according to ALA’s Office of Intellectual Freedom. In addition it is estimated that 80-90% of challenges go unreported.
Books that are challenged or banned are often cited for content that is sexually explicit, that includes profanity, offensive political views, or supporting alternative viewpoints. Typically we conjure up examples of parents or an irate citizen complaining about the aforementioned examples. But, sometimes progressive citizens also want to challenge a book’s presence in the library or on the curriculum. As librarians and readers, we need to confront our own fears and bias before responding to these challenges. Whether you’re a reader or not, it is important to be open to new ideas and to read outside our comfort zone whatever that might be.
Words have power. And when access is taken away to those words, we disenfranchise a large segment of our population. With the recent rise of intolerance it is important to remember that authors have the freedom to write and we have the freedom to read. The ALA’s Library Bill of Rights states, “…Materials should not be excluded because of the origin, background, or views of those contributing to their creation.”
Even books that may seem benign have been challenged over the years. For instance, Making Life Choices: Health Skills and Concepts, Wellness: Stress Management, and the Illustrated Encyclopedia of Family Health have been challenged for mentioning sexually transmitted diseases, failing to mention Christian prayer as an treatment for stress management, and illustrations depicting sexual intercourse.
More recently, the Immortal Life of Henrietta Lacks, received a challenge in 2015 when a parent not only wanted to limit her teenage son’s access to the book but didn’t want other students access and requested it be removed from the county school system all together. She considered the book “pornographic” because of the graphic wording, citing such passages as the infidelity of Lacks’ spouse and how she discovered the lump on her cervix.
But what an opportunity missed for this teenage boy to learn about the health disparities that existed in more than a half century before yet still exist today. What an opportunity missed to learn about another segment of society that many of us prefer to ignore or not even acknowledge. The health disparities in this country are real but reading a dry and somewhat incomprehensible research article does not make for an easy or even an interesting read. Rebecca Skloot’s book connects readers to real people through an engaging story based on research and interviews. Her words have power, having frequently been chosen for One Book reads.
Books like The Immortal Life of Henrietta Lacks can bring awareness to those entering medical and research professions, about of the disenfranchised lives of others and the insurmountable obstacles they face. Access to these books can bring about change to how research is handled, how patients are cared for, and how information is conveyed. Facing our own ignorance and encouraging accountability can bring about positive changes.
So, let us celebrate our differences, our common humanity and know that reading has the ability to connect, inspire, and bring change. Join ALA in celebrating the right to read by joining in this year’s 2017 campaign–
“Words Have Power. Read a Banned Book.”